Organization
WESTON PAXXON PT OT & SLP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER RAYMOND BERKLEY JR. PT (EXECUTIVE VP)
(631) 467-3700
Entity
Organization
Contact information
Practice address
4089 NESCONSET HWY, SOUTH SETAUKET, NY 11720-1260
(631) 331-1988
(631) 331-1988
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
(610) 991-2034
(610) 438-2046
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
003194-1
NY
Other
Enumeration date
07/05/2006
Last updated
10/12/2007
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