Provider Demographics
NPI:1154825784
Name:WESTBURY PHYSICAL THERAPY AND CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:WESTBURY PHYSICAL THERAPY AND CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-334-7000
Mailing Address - Street 1:1065 OLD COUNTRY RD STE 214
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5628
Mailing Address - Country:US
Mailing Address - Phone:631-334-7000
Mailing Address - Fax:
Practice Address - Street 1:1065 OLD COUNTRY RD STE 214
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5628
Practice Address - Country:US
Practice Address - Phone:631-334-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-20
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty