Provider Demographics
NPI:1184275026
Name:ISLAND PHYSICAL THERAPY AND CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:ISLAND PHYSICAL THERAPY AND CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-360-7999
Mailing Address - Street 1:740 VETERANS MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2329
Mailing Address - Country:US
Mailing Address - Phone:631-360-7999
Mailing Address - Fax:631-366-4473
Practice Address - Street 1:740 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2329
Practice Address - Country:US
Practice Address - Phone:631-360-7999
Practice Address - Fax:631-366-4473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty