# PERFORMANCE HOME CARE PHYSICAL THERAPY PC

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

## Provider details

- **NPI number:** 1659445658
- **Authorized official:** VICTOR MICHAEL SACKETT III P.T. (PRESIDENT)
- **Authorized official phone:** (516) 695-4998

## Contact information

- **Practice address:** 14 COSGROVE DR, GLEN COVE, NY 11542-2601
- **Practice address phone:** (516) 695-4998
- **Practice address fax:** (516) 801-0428
- **Mailing address:** 14 COSGROVE DR, GLEN COVE, NY 11542-2601
- **Mailing address phone:** (516) 695-4998
- **Mailing address fax:** (516) 801-0428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 014736 | NY | Yes |

## Other

- **Enumeration date:** 11/20/2006
- **Last updated:** 07/08/2008