Organization
NORTH SHORE - LIJ HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN ETTINGER MSPT (PHYSICAL THERAPIST)
(516) 627-8470
Entity
Organization
Contact information
Practice address
1554 NORTHERN BLVD, PM&R, MANHASSET, NY 11030-3006
(516) 627-8670
Mailing address
3 CORNWALL LN, APT A1J, CARLE PLACE, NY 11514-1086
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
026037
NY
Other
Enumeration date
03/23/2007
Last updated
08/22/2020
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