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General NPI Number Information
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NPI Number | 1922159359
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Entity Type | Organization
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Legal Business Name | PERFORM PHYSICAL THERAPY AND PILATES PLLC
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 06/14/2008
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Provider Practice Location Address
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Address Line | 141 LIDO BLVD
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City | LIDO BEACH
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State | NY
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Zip | 11561-4833
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Country | US
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Telephone | 516-220-4177
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Fax | 516-992-2282
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Provider Business Mailing Address
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Address Line | 141 LIDO BLVD
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City | LIDO BEACH
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State | NY
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Zip | 11561-4833
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Country | US
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Telephone | 516-220-4177
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Fax | 516-992-2282
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELINDA STOSKI
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Credential | PT, DPT,MS,OCS,CPI
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Telephone | 516-220-4177
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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 | 013055
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License Number State | NY
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