Provider Demographics
NPI:1942297379
Name:SOUND PHYSICAL THERAPY & WELLNESS PC
Entity Type:Organization
Organization Name:SOUND PHYSICAL THERAPY & WELLNESS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:LUCHSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:631-265-6326
Mailing Address - Street 1:319 MIDDLE COUNTRY RD
Mailing Address - Street 2:STE 4
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-2819
Mailing Address - Country:US
Mailing Address - Phone:631-265-6326
Mailing Address - Fax:631-265-5893
Practice Address - Street 1:319 MIDDLE COUNTRY RD
Practice Address - Street 2:STE 4
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2819
Practice Address - Country:US
Practice Address - Phone:631-265-6326
Practice Address - Fax:631-265-5893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0089961225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ2WWZ1Medicare PIN