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Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Active
Organization
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN BRUSH (CREDENTIALING MANAGER)
(631) 359-5805
Entity
Organization
Contact information
Practice address
2599 BROADWAY, LOWER LEVEL SUITE B, NEW YORK, NY 10025-5655
(212) 222-2270
(212) 222-2280
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
03/13/2019
Last updated
03/22/2019
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