Healthcare Provider Details

I. General information

NPI: 1356404198
Provider Name (Legal Business Name): NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 05/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 IRVING PL
WOODMERE NY
11598-1241
US

IV. Provider business mailing address

569 E MAIN STREET
BAY SHORT NY
11706-8505
US

V. Phone/Fax

Practice location:
  • Phone: 516-295-5550
  • Fax: 516-295-2789
Mailing address:
  • Phone: 631-665-8645
  • Fax: 631-665-8646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251C2600X
TaxonomyCardiopulmonary Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. IRENE DEL PERCIO
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 631-665-8645