Healthcare Provider Details

I. General information

NPI: 1114716529
Provider Name (Legal Business Name): ENGAGE PT OT PERFORMANCE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2025
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 BROADWAY
WOODMERE NY
11598-1733
US

IV. Provider business mailing address

945 BROADWAY
WOODMERE NY
11598-1733
US

V. Phone/Fax

Practice location:
  • Phone: 516-374-5310
  • Fax: 516-374-4450
Mailing address:
  • Phone: 516-374-5310
  • Fax: 516-374-4450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL VAPNE
Title or Position: AUTHORIZED OFFICIAL
Credential: DPT
Phone: 770-876-5457