Provider Demographics
NPI:1912219601
Name:JOINT EFFORT THERAPEUTICS PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:JOINT EFFORT THERAPEUTICS PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GUGLIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, OCS, COMT
Authorized Official - Phone:631-929-7276
Mailing Address - Street 1:2397 N WADING RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792-1411
Mailing Address - Country:US
Mailing Address - Phone:631-929-7276
Mailing Address - Fax:631-929-7276
Practice Address - Street 1:2397 N WADING RIVER RD
Practice Address - Street 2:
Practice Address - City:WADING RIVER
Practice Address - State:NY
Practice Address - Zip Code:11792-1411
Practice Address - Country:US
Practice Address - Phone:631-929-7276
Practice Address - Fax:631-929-7276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015702-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty