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Organization
LIGHTHOUSE PHYSICAL THERAPY, P.C.
Active
Organization
LIGHTHOUSE PHYSICAL THERAPY, P.C.
Active
Other names
Lighthouse P.T., P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER NICODEMO-CAPRA M.A., P.T. (OWNER)
(516) 808-4230
Entity
Organization
Contact information
Practice address
2 WALTON WAY, CORAM, NY 11727-1001
(516) 808-4230
(631) 331-0320
Mailing address
2 WALTON WAY, CORAM, NY 11727-1001
(516) 808-4230
(631) 331-0320
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
015513
NY
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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