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General NPI Number Information
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NPI Number | 1205040359
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Entity Type | Organization
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Legal Business Name | LINEHAN PHYSICAL THERAPY OF LONG ISLAND, PC
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 03/13/2013
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Provider Practice Location Address
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Address Line | 650 HAWKINS AVE SUITE 4
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City | RONKONKOMA
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State | NY
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Zip | 11779-2366
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Country | US
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Telephone | 631-981-7422
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Fax | 631-981-2490
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Provider Business Mailing Address
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Address Line | PO BOX 144
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City | RONKONKOMA
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State | NY
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Zip | 11779-0144
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Country | US
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Telephone | 631-981-7422
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Fax | 631-981-2490
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | MS. KAREN LINEHAN
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Credential | M.PT
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Telephone | 631-981-7422
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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 | NY
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