Healthcare Provider Details

I. General information

NPI: 1356966550
Provider Name (Legal Business Name): POWERFUL PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 N OCEAN AVE STE 4
PATCHOGUE NY
11772-2016
US

IV. Provider business mailing address

157 N OCEAN AVE STE 4
PATCHOGUE NY
11772-2016
US

V. Phone/Fax

Practice location:
  • Phone: 631-317-1222
  • Fax:
Mailing address:
  • Phone: 631-317-1222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CATHERINE POWELL
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 631-317-1222