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Organization
PREMIER PHYSICAL THERAPY OF LONG ISLAND PC
Active
Organization
PREMIER PHYSICAL THERAPY OF LONG ISLAND PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW DAVID ANGELILLO DPT (DIRECTOR)
(111) 111-1111
Entity
Organization
Contact information
Practice address
1 TERRY ST, PATCHOGUE, NY 11772-1720
(111) 111-1111
Mailing address
84 PACIFIC BLVD, LONG BEACH, NY 11561-4700
(516) 698-2930
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
024794
NY
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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