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General NPI Number Information
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NPI Number | 1639711682
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Entity Type | Organization
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Legal Business Name | ASCENT PHYSICAL THERAPY
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Dates
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Enumeration Date | 10/11/2019
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 1631 LITTLE NECK AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-1809
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Country | US
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Telephone | 516-287-3438
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Fax |
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Provider Business Mailing Address
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Address Line | 1631 LITTLE NECK AVE
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City | NORTH BELLMORE
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State | NY
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Zip | 11710-1809
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Country | US
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Telephone | 516-287-3438
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Fax |
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | DR. ROBERT WILLIAM BERGHORN JR.
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Credential | DPT, ATC, USAW
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Telephone | 516-287-3438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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