# PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC

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

## Provider details

- **NPI number:** 1972053478
- **Authorized official:** KATHLEEN BRUSH (CREDENTIALING MANAGER)
- **Authorized official phone:** (631) 359-5859

## Contact information

- **Practice address:** 1290 SUMMER ST STE 2000, STAMFORD, CT 06905-5360
- **Practice address phone:** (203) 307-4600
- **Practice address fax:** (203) 307-4601
- **Mailing address:** 576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
- **Mailing address phone:** (631) 359-5859
- **Mailing address fax:** (631) 396-0865

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | Yes |
| 225X00000X | Occupational Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/07/2016
- **Last updated:** 03/22/2018