Provider Demographics
NPI:1467527978
Name:HOMIS, CRAIG S (PT)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:S
Last Name:HOMIS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 SYLVAN AVE
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-1929
Mailing Address - Country:US
Mailing Address - Phone:631-726-8520
Mailing Address - Fax:631-726-8291
Practice Address - Street 1:SOUTHAMPTON HOSPITAL- REHAB DEPT
Practice Address - Street 2:240 MEETING HOUSE LANE
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968
Practice Address - Country:US
Practice Address - Phone:631-726-8520
Practice Address - Fax:631-726-8291
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist