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General NPI Number Information
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NPI Number | 1700685898
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 03/11/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 234 AIRPORT PLAZA BLVD STE 2 2ND FL STE 11D
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City | FARMINGDALE
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State | NY
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Zip | 11735-3936
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Country | US
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Telephone | 631-270-5977
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Fax | 631-270-5970
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Provider Business Mailing Address
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Address Line | 576 BROADHOLLOW RD
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City | MELVILLE
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State | NY
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Zip | 11747-5012
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | ALEXA MERLOS
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Credential |
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Telephone | 631-359-5859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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