Organization
SOUTH SHORE PEDIATRIC PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE VITO (SERVICE COORDINATOR)
(516) 946-0547
Entity
Organization
Contact information
Practice address
2415 JERUSALEM AVE, NORTH BELLMORE, NY 11710-1870
(516) 785-5257
Mailing address
86 MELROSE AVE, LYNBROOK, NY 11563-3703
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/10/2016
Last updated
08/10/2016
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