Healthcare Provider Details

I. General information

NPI: 1427604370
Provider Name (Legal Business Name): ACHIEVE WELLNESS PT OT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2019
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 ROUTE 25A
ROCKY POINT NY
11778-9091
US

IV. Provider business mailing address

170 ROUTE 25A
ROCKY POINT NY
11778-9091
US

V. Phone/Fax

Practice location:
  • Phone: 631-922-0283
  • Fax:
Mailing address:
  • Phone: 631-922-0283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: NATALIE THOMPSON
Title or Position: PATNER
Credential: PT
Phone: 631-922-0283