Provider Demographics
NPI:1851756902
Name:MICHELLE MUSETTI PT PC
Entity Type:Organization
Organization Name:MICHELLE MUSETTI PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SATUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-878-7012
Mailing Address - Street 1:225 MONTAUK HWY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11955-1425
Mailing Address - Country:US
Mailing Address - Phone:631-878-7012
Mailing Address - Fax:631-878-7015
Practice Address - Street 1:225 MONTAUK HWY
Practice Address - Street 2:SUITE 109
Practice Address - City:MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11955-1425
Practice Address - Country:US
Practice Address - Phone:631-878-7012
Practice Address - Fax:631-878-7015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020627-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY814748OtherTHE EMPIRE PLAN
NYA400066685Medicare PIN