Provider Demographics
NPI:1417564253
Name:SUFFOLK PHYSICAL THERAPY & CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:SUFFOLK PHYSICAL THERAPY & CHIROPRACTIC, PLLC
Other - Org Name:SUFFOLK PHYSICAL THERAPY & CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:DOW
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-249-0011
Mailing Address - Street 1:PO BOX 1359
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-0308
Mailing Address - Country:US
Mailing Address - Phone:631-249-0011
Mailing Address - Fax:631-249-1793
Practice Address - Street 1:535 BROADHOLLOW RD STE A22
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3725
Practice Address - Country:US
Practice Address - Phone:631-249-0011
Practice Address - Fax:631-249-1793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty