# NY PHYSICAL THERAPY IN HOME THERAPY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043813306
- **Authorized official:** MARK DIAZ PT (OWNER/PT)
- **Authorized official phone:** (516) 261-9510

## Contact information

- **Practice address:** 650 WANTAGH AVE, LEVITTOWN, NY 11756-5390
- **Practice address phone:** (516) 261-9510
- **Practice address fax:** (516) 597-5541
- **Mailing address:** 650 WANTAGH AVE, LEVITTOWN, NY 11756-5390
- **Mailing address phone:** (162) 619-5105
- **Mailing address fax:** (516) 597-5541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/19/2020
- **Last updated:** 02/18/2021