Provider Demographics
NPI:1669003042
Name:LIVE LONG IN HOME PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PLLC
Entity Type:Organization
Organization Name:LIVE LONG IN HOME PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:MORANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:877-644-8090
Mailing Address - Street 1:841 COUNTY ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:EAST CHATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12060-3022
Mailing Address - Country:US
Mailing Address - Phone:877-644-8090
Mailing Address - Fax:646-839-2598
Practice Address - Street 1:841 COUNTY ROUTE 5
Practice Address - Street 2:
Practice Address - City:EAST CHATHAM
Practice Address - State:NY
Practice Address - Zip Code:12060-3022
Practice Address - Country:US
Practice Address - Phone:877-644-8090
Practice Address - Fax:646-839-2598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-04
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty