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NPI Code Detail

MEDICARE: SAUNDRA J PERRY P.T.

MEDICARE: SAUNDRA J PERRY P.T.
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 Therapist06894NY
22251C2600XCardiopulmonary Physical Therapist06894NY
32251G0304XGeriatric Physical Therapist06894NY
42251N0400XNeurology Physical Therapist06894NY
52251P0200XPediatric Physical Therapist06894NY
62251X0800XOrthopedic Physical Therapist06894NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A2527929OTHERNYORTHONET
2AZ00670OTHERNYMDNY

General Provider Information

NPI Number : 1417906116
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAUNDRA J PERRY P.T.
Provider Business Mailing Address
First Line : 57190 MAIN RD
Second Line : POBOX 1824
City : SOUTHOLD
State : NY
Zip : 11971-4750
Country : US
Telephone Number : 631-765-3620
Fax Number : 631-765-0013
Provider Business Practice Location Address
First Line : 57190 MAIN RD
Second Line :
City : SOUTHOLD
State : NY
Zip : 11971-4750
Country : US
Telephone Number : 631-765-3620
Fax Number : 631-765-0013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 09/11/2025

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