MEDICARE: JACLYN SARAH CAHILL DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	041001	NY

General Provider Information

NPI Number	:	1053852970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACLYN SARAH CAHILL DPT

Provider Business Mailing Address
First Line	:	3385 VETERANS MEMORIAL HWY STE I
Second Line	:
City	:	RONKONKOMA
State	:	NY
Zip	:	11779-7660
Country	:	US
Telephone Number	:	631-665-4560
Fax Number	:	631-665-7213

Provider Business Practice Location Address
First Line	:	131 W MAIN ST
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-8315
Country	:	US
Telephone Number	:	631-665-4560
Fax Number	:	631-665-7213

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	03/23/2026

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