Provider Demographics
NPI:1023361557
Name:HENRY G PURSLOW PT PC
Entity Type:Organization
Organization Name:HENRY G PURSLOW PT PC
Other - Org Name:FARMINGDALE PHYSICAL THERAPY WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:PROCHILO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-731-3583
Mailing Address - Street 1:4277 HEMPSTEAD TPKE STE 209A
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5706
Mailing Address - Country:US
Mailing Address - Phone:516-731-3583
Mailing Address - Fax:516-731-3587
Practice Address - Street 1:4277 HEMPSTEAD TPKE STE 209A
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5706
Practice Address - Country:US
Practice Address - Phone:516-731-3583
Practice Address - Fax:516-731-3587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty