Healthcare Provider Details

I. General information

NPI: 1013349893
Provider Name (Legal Business Name): WESTBURY PHYSICAL THERAPY AND CHIROPRACTIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 08/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 POST AVE SUITE 100
WESTBURY NY
11590-2257
US

IV. Provider business mailing address

320 POST AVE SUITE 100
WESTBURY NY
11590-2257
US

V. Phone/Fax

Practice location:
  • Phone: 516-280-7180
  • Fax: 516-255-9130
Mailing address:
  • Phone: 516-280-7180
  • Fax: 516-255-9130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberX009660
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. LEE A WEINER
Title or Position: OWNER
Credential: DC
Phone: 516-578-5373