Provider Demographics
NPI:1114263308
Name:EAST HAMPTON PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:EAST HAMPTON PHYSICAL THERAPY PLLC
Other - Org Name:EH PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:LYS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:631-668-7600
Mailing Address - Street 1:6 S ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MONTAUK
Mailing Address - State:NY
Mailing Address - Zip Code:11954-5421
Mailing Address - Country:US
Mailing Address - Phone:631-668-7600
Mailing Address - Fax:631-668-7603
Practice Address - Street 1:6 S ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:MONTAUK
Practice Address - State:NY
Practice Address - Zip Code:11954-5421
Practice Address - Country:US
Practice Address - Phone:631-668-7600
Practice Address - Fax:631-668-7603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027331-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty