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General NPI Number Information
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NPI Number | 1740846443
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Entity Type | Organization
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Legal Business Name | FIRE ISLAND PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 12/31/2021
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Provider Practice Location Address
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Address Line | 786 EVERGREEN WALK
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City | OCEAN BEACH
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State | NY
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Zip | 11770-2025
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Country | US
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Telephone | 631-300-8787
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Fax | 631-532-4012
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Provider Business Mailing Address
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Address Line | PO BOX 328
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City | OCEAN BEACH
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State | NY
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Zip | 11770-0328
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Country | US
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Telephone | 631-300-8787
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Fax | 631-532-4012
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | EILEEN HENRY
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Credential | DPT
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Telephone | 631-300-8787
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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