Provider Demographics
NPI:1891564704
Name:SPIRITO GATHMAN PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:SPIRITO GATHMAN PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:SPIRITO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:631-740-0014
Mailing Address - Street 1:81 FORT SALONGA RD STE C
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2889
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 TECHNOLOGY DR
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-4000
Practice Address - Country:US
Practice Address - Phone:631-606-6075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOVEMENT HEADQUARTERS PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy