Healthcare Provider Details

I. General information

NPI: 1578583985
Provider Name (Legal Business Name): NEW YORK PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MANETTO HILL RD SUITE #105A
PLAINVIEW NY
11803-1311
US

IV. Provider business mailing address

120 NEWHAM AVE
BRENTWOOD NY
11717-5624
US

V. Phone/Fax

Practice location:
  • Phone: 516-932-5260
  • Fax: 888-215-5172
Mailing address:
  • Phone: 631-813-2143
  • Fax: 888-552-6176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: CYNDI GREENE
Title or Position: MANAGED CARE DIRECTOR
Credential:
Phone: 631-813-2143