MEDICARE: MELISSA A GROVER PT

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	23443	NY

General Provider Information

NPI Number	:	1700807252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA A GROVER PT

Provider Business Mailing Address
First Line	:	32 LAWRENCE AVE STE 107
Second Line	:
City	:	SMITHTOWN
State	:	NY
Zip	:	11787-3605
Country	:	US
Telephone Number	:	631-265-5702
Fax Number	:	631-265-9014

Provider Business Practice Location Address
First Line	:	32 LAWRENCE AVE STE 107
Second Line	:
City	:	SMITHTOWN
State	:	NY
Zip	:	11787-3605
Country	:	US
Telephone Number	:	631-265-5702
Fax Number	:	631-265-9014

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	03/03/2026

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Directions to “ MELISSA A GROVER PT” Practice Location

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