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NPI 1013638857

NPI 1013638857 : SKYLER MORAKKABI PT : SOUTH SETAUKET, NY

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General NPI Number Information
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    NPI Number           |    1013638857
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    Entity Type          |    Individual 
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    Provider Name        |    SKYLER MORAKKABI PT
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/09/2022
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    Last Update Date     |    09/09/2022
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Provider Practice Location Address
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    Address Line         |    1 JEFFERSON FERRY DR 
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    City                 |    SOUTH SETAUKET
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    State                |    NY
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    Zip                  |    11720-4708
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    Country              |    US
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    Telephone            |    631-650-2700
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    98 CEDAR POINT DR 
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    City                 |    WEST ISLIP
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    State                |    NY
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    Zip                  |    11795-5014
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    Country              |    US
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    Telephone            |    516-319-9103
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    049022
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    License Number State |    NY
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