Organization
NY SPINE PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE VICTOR HATAMI PT (OWNER)
(631) 447-6100
Entity
Organization
Contact information
Practice address
475 E MAIN ST, SUITE 103-105, PATCHOGUE, NY 11772-3121
(631) 447-6100
(631) 447-6126
Mailing address
475 E MAIN ST, SUITE 103-105, PATCHOGUE, NY 11772-3121
(631) 447-6100
(631) 447-6126
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
016816-1
NY
Other
Enumeration date
06/25/2006
Last updated
03/14/2008
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