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NPI Code Detail

MEDICARE: ALL STAR PHYSICAL THERAPY AND REHABILITION P.C.

MEDICARE: ALL STAR PHYSICAL THERAPY AND REHABILITION P.C.
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
1225100000XPhysical Therapist022570NY

General Provider Information

NPI Number : 1184735268
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALL STAR PHYSICAL THERAPY AND REHABILITION P.C.
Provider Business Mailing Address
First Line : 16 MEMORIAL BLVD
Second Line :
City : EAST MORICHES
State : NY
Zip : 11940-1436
Country : US
Telephone Number : 631-525-6828
Fax Number :
Provider Business Practice Location Address
First Line : 16 MEMORIAL BLVD
Second Line :
City : EAST MORICHES
State : NY
Zip : 11940-1436
Country : US
Telephone Number : 631-525-6828
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : PETER MICHAEL FISCINA
Credential : PT
Telephone Number : 631-525-6828
Provider Enumeration Date : 08/31/2006
Last Update Date : 05/21/2014

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Directions to “ALL STAR PHYSICAL THERAPY AND REHABILITION P.C. ” Practice Location

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