Provider Demographics
NPI:1861428195
Name:MADEY, LES (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MR
First Name:LES
Middle Name:
Last Name:MADEY
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 STONEHINGE LANE
Mailing Address - Street 2:
Mailing Address - City:CARLE PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11514-1718
Mailing Address - Country:US
Mailing Address - Phone:516-333-7771
Mailing Address - Fax:516-333-3463
Practice Address - Street 1:208 STONEHINGE LANE
Practice Address - Street 2:
Practice Address - City:CARLE PLACE
Practice Address - State:NY
Practice Address - Zip Code:11514-1718
Practice Address - Country:US
Practice Address - Phone:516-333-7771
Practice Address - Fax:516-333-3463
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-26
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13567-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist