Healthcare Provider Details

I. General information

NPI: 1780626309
Provider Name (Legal Business Name): PLAINVIEW PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 OLD COUNTRY RD STE 153LL
PLAINVIEW NY
11803-4942
US

IV. Provider business mailing address

875 OLD COUNTRY RD STE 153LL
PLAINVIEW NY
11803-4942
US

V. Phone/Fax

Practice location:
  • Phone: 516-935-1958
  • Fax: 516-827-0714
Mailing address:
  • Phone: 516-935-1958
  • Fax: 516-827-0714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number022744-1 NY
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHIVALINI PATEL
Title or Position: OWNER/PRESIDENT/PHYSICAL THERAPIST
Credential: MPT
Phone: 516-935-1958