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General NPI Number Information
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NPI Number | 1356325799
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Entity Type | Organization
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Legal Business Name | PHYSIOLOGIC PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 05/12/2025
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Provider Practice Location Address
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Address Line | 98 CUTTERMILL RD #100
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 516-466-4118
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Fax | 516-466-2856
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Provider Business Mailing Address
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Address Line | 98 CUTTERMILL RD #100
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City | GREAT NECK
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State | NY
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Zip | 11021
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Country | US
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Telephone | 516-466-4118
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Fax | 516-466-2856
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | STEPHEN C HOFMAYER
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Credential | MSPT
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Telephone | 516-466-4118
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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 | 0084451
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License Number State | NY
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