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General NPI Number Information
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NPI Number | 1386501765
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Entity Type | Organization
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Legal Business Name | SPORTS PHYSICAL THERAPY OCCUPATIONAL THERAPY AND REHABILITATION SERVIC
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 410 LAKEVILLE RD STE 303
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1104
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Country | US
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Telephone | 516-321-7526
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Fax |
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Provider Business Mailing Address
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Address Line | 972 BRUSH HOLLOW RD FL 4
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City | WESTBURY
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State | NY
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Zip | 11590-1740
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Country | US
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Telephone | 516-321-7526
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | BRIAN KREBS
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Credential | PT, DPT
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Telephone | 516-393-8858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251H1200X
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Taxonomy Name | Hand Physical Therapist
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License Number |
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License Number State |
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