Provider Demographics
NPI:1649290057
Name:NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Entity type:Organization
Organization Name:NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:
Authorized Official - Last Name:MERITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-449-5800
Mailing Address - Street 1:763 LARKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3131
Mailing Address - Country:US
Mailing Address - Phone:631-499-5800
Mailing Address - Fax:631-462-0827
Practice Address - Street 1:605 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-8505
Practice Address - Country:US
Practice Address - Phone:631-499-5800
Practice Address - Fax:631-462-0827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ5W161Medicare PIN
Q5W141Medicare ID - Type Unspecified