Individual
MATTHEW LAGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, ATC
Contact information
Practice address
3072 JERICHO TPKE, EAST NORTHPORT, NY 11731-6214
(631) 462-9595
Mailing address
3072 JERICHO TPKE, EAST NORTHPORT, NY 11731-6214
(631) 462-9595
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
046491-01
NY
Other
Enumeration date
12/18/2020
Last updated
12/21/2020
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