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General NPI Number Information
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NPI Number | 1689778243
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Entity Type | Organization
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Legal Business Name | DAVID LIPETZ PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 1399 FRANKLIN AVE SUITE 101
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City | GARDEN CITY
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State | NY
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Zip | 11530-7400
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Country | US
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Telephone | 516-248-4264
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Fax | 516-248-4265
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Provider Business Mailing Address
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Address Line | 1399 FRANKLIN AVE SUITE 101
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City | GARDEN CITY
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State | NY
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Zip | 11530-7400
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Country | US
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Telephone | 516-248-4264
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Fax | 516-248-4265
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Authorized Official
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Title or Position | OWNER / DIRECTOR
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Name | MR. DAVID IAN LIPETZ
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Credential | P.T.
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Telephone | 516-248-4264
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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 | 026960
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License Number State | NY
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