MEDICARE: BEACH NY PHYSICAL THERAPY OF STATEN ISLAND PLLC

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1356297915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACH NY PHYSICAL THERAPY OF STATEN ISLAND PLLC

Provider Business Mailing Address
First Line	:	5405 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-5201
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5405 HYLAN BLVD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-5201
Country	:	US
Telephone Number	:	718-634-3211
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KATELYN CUSMIANI
Credential	:	DPT
Telephone Number	:	917-680-9760

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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