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General NPI Number Information
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NPI Number | 1376842658
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Entity Type | Organization
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Legal Business Name | FARMINGDALE PHYSICAL THERAPY EAST LLC
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Dates
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Enumeration Date | 03/25/2011
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Last Update Date | 03/25/2011
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Provider Practice Location Address
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Address Line | 326 MAIN ST
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City | FARMINGDALE
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State | NY
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Zip | 11735-3507
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Country | US
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Telephone | 516-293-0565
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Fax | 516-293-1897
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Provider Business Mailing Address
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Address Line | 326 MAIN ST
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City | FARMINGDALE
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State | NY
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Zip | 11735-3507
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Country | US
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Telephone | 516-293-0565
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Fax | 516-293-1897
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN C DUGAN
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Credential | PT OCS NCS GCS
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Telephone | 516-293-0565
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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 | 006358-1
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License Number State | NY
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