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General NPI Number Information
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NPI Number | 1659521979
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Entity Type | Organization
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Legal Business Name | MONTALTO PHYSICAL THERAPY, PC
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Dates
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Enumeration Date | 09/23/2008
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 123 SOUTH ST SUITE 112
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City | OYSTER BAY
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State | NY
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Zip | 11771-2251
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Country | US
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Telephone | 516-624-6739
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Fax |
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Provider Business Mailing Address
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Address Line | 123 SOUTH ST SUITE 112
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City | OYSTER BAY
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State | NY
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Zip | 11771-2251
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Country | US
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Telephone | 516-624-6739
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH GEORGE MONTALTO
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Credential | PT
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Telephone | 516-624-6739
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0190711
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License Number State | NY
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