Organization
WESTON PAXXON PT OT & SLP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROGER RAYMOND BERKLEY JR. PT (EXECUTIVE VP)
(631) 467-3700
Entity
Organization
Contact information
Practice address
345 NORTHERN BLVD, SUITE 100, ALBANY, NY 12204-1001
(518) 462-1689
(516) 468-1689
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
022235-1
NY
225X00000X
Occupational Therapist
013398-1
NY
Other
Enumeration date
08/09/2006
Last updated
06/28/2012
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