Provider Demographics
NPI:1861541328
Name:PARTRIDGE, WILLIAM T (PT)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:T
Last Name:PARTRIDGE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 JERICHO TPKE
Mailing Address - Street 2:SUITE 114W
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4436
Mailing Address - Country:US
Mailing Address - Phone:516-364-2554
Mailing Address - Fax:516-364-5328
Practice Address - Street 1:6800 JERICHO TPKE
Practice Address - Street 2:SUITE 114W
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-4436
Practice Address - Country:US
Practice Address - Phone:516-364-2554
Practice Address - Fax:516-364-5328
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ56231OtherBLUE CROSS PIN NUMBER
NYQ56231OtherBLUE CROSS PIN NUMBER
NYQ56231Medicare PIN