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Organization

PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHLEEN BRUSH (CREDENTIALING MANAGER)
(631) 359-5805
Entity
Organization

Contact information

Practice address
599 GRAMATAN AVE STE 205, FLEETWOOD, NY 10552
(914) 371-1990
(914) 371-7588
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
(631) 396-0865

Taxonomy

Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary

Other

Enumeration date
05/25/2018
Last updated
05/30/2018
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