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Organization
STEVEN C. DESOUSA, PT, PC
Active
Organization
STEVEN C. DESOUSA, PT, PC
Active
Other names
East Northport Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER A DESOUSA (OFFICE ADMINISTRATOR)
(631) 757-1791
Entity
Organization
Contact information
Practice address
554 LARKFIELD RD, SUITE 207, EAST NORTHPORT, NY 11731-4205
(631) 266-4501
(631) 266-4502
Mailing address
554 LARKFIELD RD, SUITE 207, EAST NORTHPORT, NY 11731-4205
(631) 266-4501
(631) 266-4502
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
013896-1
NY
225100000X
Physical Therapist
018783-0
NY
2251C2600X
Cardiopulmonary Physical Therapist
013896-1
NY
2251E1200X
Ergonomics Physical Therapist
013896-1
NY
2251G0304X
Geriatric Physical Therapist
013896-1
NY
2251G0304X
Geriatric Physical Therapist
018783-0
NY
2251H1200X
Hand Physical Therapist
013896-1
NY
2251N0400X
Neurology Physical Therapist
013896-1
NY
2251S0007X
Sports Physical Therapist
013896-1
NY
2251X0800X
Orthopedic Physical Therapist
013896-1
NY
225200000X
Physical Therapy Assistant
002632-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01914598
—
NY
01
—
218199P
HIP
NY
01
—
54388
VYTRA
NY
01
—
6699926
GHI
NY
01
—
A2517039
OXFORD
NY
01
—
AZ00899
MDNY
NY
01
—
Q38811
EMPIRE BC BS
NY
Enumeration date
03/09/2007
Last updated
04/20/2008
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