Healthcare Provider Details

I. General information

NPI: 1326776774
Provider Name (Legal Business Name): LUCAS DE ALMEIDA FERREIRA DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LUCAS FERREIRA PT, DPT

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 SAINT JAMES AVE S
SAINT JAMES NY
11780-2812
US

IV. Provider business mailing address

152 SAINT JAMES AVE S
SAINT JAMES NY
11780-2812
US

V. Phone/Fax

Practice location:
  • Phone: 203-615-8308
  • Fax:
Mailing address:
  • Phone: 203-615-8308
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number055449
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13645
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: