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General NPI Number Information
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NPI Number | 1558791335
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Entity Type | Organization
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Legal Business Name | MOVEMENT CONCEPTS PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 55 MAPLE AVE SUITE 306
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-4274
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Country | US
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Telephone | 516-227-5344
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Fax | 516-908-6222
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Provider Business Mailing Address
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Address Line | 55 MAPLE AVE SUITE 306
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-227-5344
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Fax | 516-908-6222
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTIN D CONFORTI
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Credential | MPT, DPT
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Telephone | 516-698-0708
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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 | 030587-1
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License Number State | NY
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