Provider Demographics
NPI:1356404198
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:OPERATIONS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL PERCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-665-8645
Mailing Address - Street 1:569 E MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BAY SHORT
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8505
Mailing Address - Country:US
Mailing Address - Phone:631-665-8645
Mailing Address - Fax:631-665-8646
Practice Address - Street 1:158 IRVING PL
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1241
Practice Address - Country:US
Practice Address - Phone:516-295-5550
Practice Address - Fax:516-295-2789
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-19
Last Update Date:2009-05-07
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
No2251C2600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistCardiopulmonaryGroup - Single Specialty
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ0W1B1Medicare PIN
QOW1B1Medicare UPIN
NYQOW1B1Medicare ID - Type Unspecified