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General NPI Number Information
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NPI Number | 1457321911
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Entity Type | Individual
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Provider Name | STEVEN C DESOUSA PT
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 554 LARKFIELD RD SUITE 207
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4205
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Country | US
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Telephone | 631-266-4501
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Fax | 631-266-4502
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Provider Business Mailing Address
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Address Line | 554 LARKFIELD RD SUITE 207
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City | EAST NORTHPORT
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State | NY
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Zip | 11731-4205
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Country | US
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Telephone | 631-266-4501
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Fax | 631-266-4502
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0138961
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License Number State | NY
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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 | 0138961
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 0138961
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 0138961
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License Number State | NY
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