Provider Demographics
NPI:1760616593
Name:MERRICK PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:MERRICK PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:RUISI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-223-4300
Mailing Address - Street 1:2092 MERRICK AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3147
Mailing Address - Country:US
Mailing Address - Phone:516-223-4300
Mailing Address - Fax:516-223-1142
Practice Address - Street 1:2092 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3147
Practice Address - Country:US
Practice Address - Phone:516-223-4300
Practice Address - Fax:516-223-1142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty