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Organization
MICHAEL SCOTTODIMASO AND TARA DEROSA, PT, OT, PLLC
Active
Organization
MICHAEL SCOTTODIMASO AND TARA DEROSA, PT, OT, PLLC
Active
Other names
CBC Ctr for Sports & Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SCOTTODIMASO PT (OWNER)
(631) 669-0333
Entity
Organization
Contact information
Practice address
51 JOHN ST STE 3, BABYLON, NY 11702-2928
(631) 669-0333
(631) 669-2436
Mailing address
51 JOHN ST STE 3, BABYLON, NY 11702-2928
(631) 669-0333
(631) 669-2436
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0129451
NY
225100000X
Physical Therapist
Primary
0129451
NY
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
11/05/2008
Last updated
03/20/2026
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