=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083805352
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACHIEVE PHYSICAL THERAPY AND REHABILITATION OF LONG ISLAND PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2007
-----------------------------------------------------
Last Update Date | 07/30/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1800 ROCKAWAY AVE SUITE 100
-----------------------------------------------------
City | HEWLETT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11557-1665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-593-4530
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1800 ROCKAWAY AVE SUITE 100
-----------------------------------------------------
City | HEWLETT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11557-1665
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-593-4530
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST
-----------------------------------------------------
Name | DANIEL H. ARYEH
-----------------------------------------------------
Credential | P.T.
-----------------------------------------------------
Telephone | 5165168496068
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 025991-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------