Healthcare Provider Details

I. General information

NPI: 1558581447
Provider Name (Legal Business Name): SYOSSET PHYSICAL THERAPY AND REHABILITATION, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 COLD SPRING RD
SYOSSET NY
11791-3109
US

IV. Provider business mailing address

85 COLD SPRING RD
SYOSSET NY
11791-3109
US

V. Phone/Fax

Practice location:
  • Phone: 516-496-9860
  • Fax: 516-496-9871
Mailing address:
  • Phone: 516-496-9860
  • Fax: 516-496-9871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number006542
License Number StateNY

VIII. Authorized Official

Name: MR. ORRIN LOUIS DAYTON II
Title or Position: OWNER
Credential: P.T.
Phone: 516-496-9860