Provider Demographics
NPI:1750685376
Name:ONEONONEPT PLLC
Entity Type:Organization
Organization Name:ONEONONEPT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:MANTAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KORSAKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-284-9258
Mailing Address - Street 1:1149 ROUTE 58 STE A2
Mailing Address - Street 2:
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2059
Mailing Address - Country:US
Mailing Address - Phone:631-428-6235
Mailing Address - Fax:
Practice Address - Street 1:1149 ROUTE 58 STE A2
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-2059
Practice Address - Country:US
Practice Address - Phone:631-284-9258
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-23
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty