Provider Demographics
NPI:1811132186
Name:SPECTRUM PHYSICAL THERAPY & CHIROPRACTIC OF LEVITTOWN, PLLC
Entity type:Organization
Organization Name:SPECTRUM PHYSICAL THERAPY & CHIROPRACTIC OF LEVITTOWN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANA
Authorized Official - Middle Name:LORI
Authorized Official - Last Name:HERR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-731-1980
Mailing Address - Street 1:3272 HEMPSTEAD TPKE
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-1345
Mailing Address - Country:US
Mailing Address - Phone:516-731-1980
Mailing Address - Fax:
Practice Address - Street 1:3272 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-1345
Practice Address - Country:US
Practice Address - Phone:516-731-1980
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007197261QM1300X
NY019821261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty