Provider Demographics
NPI:1891100699
Name:SL PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:SL PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:EVAN
Authorized Official - Last Name:LIPTZIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-557-9564
Mailing Address - Street 1:140 NORTHERN PKWY W
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-1933
Mailing Address - Country:US
Mailing Address - Phone:516-557-9564
Mailing Address - Fax:
Practice Address - Street 1:140 NORTHERN PKWY W
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1933
Practice Address - Country:US
Practice Address - Phone:516-557-9564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty