MEDICARE: PHYSICAL THERAPY OF HICKSVILLE 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1730548116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY OF HICKSVILLE PLLC

Provider Business Mailing Address
First Line	:	265 N BROADWAY
Second Line	:
City	:	HICKSVILLE
State	:	NY
Zip	:	11801-2933
Country	:	US
Telephone Number	:	516-605-2200
Fax Number	:	516-605-2203

Provider Business Practice Location Address
First Line	:	265 N BROADWAY
Second Line	:
City	:	HICKSVILLE
State	:	NY
Zip	:	11801-2933
Country	:	US
Telephone Number	:	516-605-2200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANNIE JOSEPH
Credential	:
Telephone Number	:	631-885-3831

Provider Enumeration Date	:	02/15/2016
Last Update Date	:	02/18/2026

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