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General NPI Number Information
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NPI Number | 1770622854
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Entity Type | Organization
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Legal Business Name | ISLAND PHYSICAL THERAPY OF RIVERHEAD
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 10/11/2023
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Provider Practice Location Address
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Address Line | 185 OLD COUNTRY RD SUITE 4
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City | RIVERHEAD
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State | NY
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Zip | 11901
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Country | US
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Telephone | 631-208-4443
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Fax | 631-208-4448
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Provider Business Mailing Address
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Address Line | 185 OLD COUNTRY RD SUITE 4
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City | RIVERHEAD
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State | NY
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Zip | 11901
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Country | US
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Telephone | 631-208-4443
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Fax | 631-208-4448
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Authorized Official
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Title or Position | CO OWNER PRESIDENT
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Name | DR. VINCENT J BARRY
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Credential | PT DPT
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Telephone | 631-208-4443
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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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