=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700502507
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PERSPECTIVES PHYSICAL THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2022
-----------------------------------------------------
Last Update Date | 10/15/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 91 COUNTRY CLUB DR
-----------------------------------------------------
City | PORT WASHINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11050-4535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-243-7041
-----------------------------------------------------
Fax | 516-386-0376
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 91 COUNTRY CLUB DR
-----------------------------------------------------
City | PORT WASHINGTON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11050-4535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-243-7041
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. CORINNA LAU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-283-3242
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------