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Organization
PRN PHYSICAL THERAPY PC
Active
Organization
PRN PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN JOSEPH PT (PRESIDENT)
(631) 467-3700
Entity
Organization
Contact information
Practice address
20 PEACHTREE CT, SUITE 105, HOLBROOK, NY 11741-4616
(631) 467-3700
(631) 467-0928
Mailing address
20 PEACHTREE CT, SUITE 105, HOLBROOK, NY 11741-4616
(631) 467-3700
(631) 467-0928
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
016663
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650021498
RAILROAD MEDICARE
NY
Enumeration date
06/29/2006
Last updated
03/08/2021
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