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General NPI Number Information
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NPI Number | 1467909408
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Entity Type | Organization
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Legal Business Name | CORE KINETICS PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 09/07/2016
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Last Update Date | 08/04/2023
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Provider Practice Location Address
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Address Line | 177 CONKLIN ST
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City | FARMINGDALE
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State | NY
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Zip | 11735-2501
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Country | US
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Telephone | 516-526-5196
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Fax | 631-351-4049
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Provider Business Mailing Address
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Address Line | 28 PIERMONT CT
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City | MELVILLE
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State | NY
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Zip | 11747-1410
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Country | US
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Telephone | 516-526-5196
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Fax | 631-351-4049
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH PATRICK KEATING II
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Credential |
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Telephone | 516-526-5196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 031523-1
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License Number State | NY
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