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General NPI Number Information
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NPI Number | 1154352888
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Entity Type | Organization
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Legal Business Name | GENERATIONS PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 09/01/2015
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Provider Practice Location Address
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Address Line | 400 MONTAUK HWY SUITE 103
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City | WEST ISLIP
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State | NY
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Zip | 11795-4208
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Country | US
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Telephone | 631-661-3700
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Fax | 631-661-3749
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Provider Business Mailing Address
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Address Line | 400 MONTAUK HWY SUITE 103
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City | WEST ISLIP
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State | NY
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Zip | 11795-4208
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Country | US
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Telephone | 631-661-3700
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Fax | 631-661-3749
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Authorized Official
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Title or Position | OFFICE MGR.
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Name | CATHY VIOLA
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Credential |
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Telephone | 631-661-3700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7484
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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