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General NPI Number Information
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NPI Number | 1235350505
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Entity Type | Organization
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Legal Business Name | ST. JAMES PLAZA
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 273 MORICHES RD
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City | SAINT JAMES
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State | NY
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Zip | 11780-2117
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Country | US
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Telephone | 631-862-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 21 COLONIAL RD
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City | SMITHTOWN
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State | NY
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Zip | 11787-3432
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Country | US
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Telephone | 631-724-5325
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. TIMOTHY J COSGRIFF
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Credential | PT
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Telephone | 631-862-8990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 015167
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 015167
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License Number State | NY
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