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General NPI Number Information
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NPI Number | 1679239057
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Entity Type | Organization
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Legal Business Name | LONG ISLAND PHYSICAL THERAPY PC
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Dates
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Enumeration Date | 11/10/2021
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 770 E JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-7503
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Country | US
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Telephone | 631-428-0334
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Fax | 631-683-4480
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Provider Business Mailing Address
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Address Line | 770 E JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-7503
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Country | US
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Telephone | 631-428-0334
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Fax | 631-683-4480
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Authorized Official
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Title or Position | WNER
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Name | WARDA JAVAID
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Credential |
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Telephone | 631-683-4000
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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 |
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License Number State |
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