Provider Demographics
NPI:1497373294
Name:COMPET, VLADIMIR (PTA)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:
Last Name:COMPET
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 WALDORF AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-1522
Mailing Address - Country:US
Mailing Address - Phone:516-661-9351
Mailing Address - Fax:
Practice Address - Street 1:59 38TH ST
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-1101
Practice Address - Country:US
Practice Address - Phone:516-341-2289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant