# LAKE SUCCESS PHYSICAL THERAPY P.C.

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

## Provider details

- **NPI number:** 1336604222
- **Authorized official:** MRS. MICHELLE DRAGAN (BUSINESS MANAGER)
- **Authorized official phone:** (516) 488-8808

## Contact information

- **Practice address:** 1999 MARCUS AVE STE M15, NEW HYDE PARK, NY 11042-1023
- **Practice address phone:** (516) 488-8808
- **Practice address fax:** (516) 488-8818
- **Mailing address:** 1999 MARCUS AVE STE M15, NEW HYDE PARK, NY 11042-1023
- **Mailing address phone:** (516) 488-8808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2251E1300X | Clinical Electrophysiology Physical Therapist | — | NULL | Yes |
| 2251E1300X | Clinical Electrophysiology Physical Therapist | — | — | Yes |

## Other

- **Enumeration date:** 02/05/2019
- **Last updated:** 02/05/2019