=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780273169
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NPPT FAMILY HEALTH NP AND PT P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/11/2021
-----------------------------------------------------
Last Update Date | 01/11/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2094 MERRICK AVE
-----------------------------------------------------
City | MERRICK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11566-3147
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-864-4602
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1490 HORSESHOE DR
-----------------------------------------------------
City | NORTH BELLMORE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11710-2458
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-322-7885
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | THOMAS YARROBINO
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 516-864-4602
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------