Organization
BAY SHORE PHYSICAL THERAPY
Active
Organization
BAY SHORE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICK PORILLICO PT (PRESIDENT)
(631) 665-2421
Entity
Organization
Contact information
Practice address
1590 UNION BLVD, BAY SHORE, NY 11706
(631) 665-2421
(631) 665-3416
Mailing address
1590 UNION BLVD, BAY SHORE, NY 11706
(631) 665-2421
(631) 665-3416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0151101
NY
Other
Enumeration date
11/17/2006
Last updated
06/11/2008
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