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General NPI Number Information
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NPI Number | 1275813990
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Entity Type | Organization
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Legal Business Name | DIX HILLS PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 08/25/2011
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Last Update Date | 08/25/2011
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Provider Practice Location Address
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Address Line | 1206 E JERICHO TPKE UNIT A
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City | HUNTINGTON
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State | NY
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Zip | 11743-5453
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Country | US
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Telephone | 631-549-1550
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Fax | 631-549-1562
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Provider Business Mailing Address
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Address Line | 1206 E JERICHO TPKE UNIT A
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City | HUNTINGTON
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State | NY
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Zip | 11743-5453
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Country | US
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Telephone | 631-549-1550
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Fax | 631-549-1562
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | HENRIQUE DOSSANTOS
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Credential | P.T.
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Telephone | 631-549-1550
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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 | 020147
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License Number State | NY
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