Main Street Physical Therapy and Hand Rehabilitation of Kings Park, PL

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

MAIN STREET PHYSICAL THERAPY AND HAND REHABILITATION OF KINGS PARK, PL

Practice address

152 W Main Street
Kings Park, NY 11754

Phone

(631) 269-6652

Fax

(631) 269-6654

NPI assigned

Nov 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Fontana, PTA

Title

Treasurer

Phone

(631) 269-6652

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Hynds, PT

  • Physical Therapist
  • Kings Park, NY
  • NPI 1578637328

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Deirdre Ingram, PT

  • Physical Therapist
  • Kings Park, NY
  • NPI 1508066838

  Physical Medicine & Rehabilitation

  Medicare reassignment Care Compare group NPD
• Robert Troiano, P.T.

  • Physical Therapist
  • Kings Park, NY
  • NPI 1912905241

  Physical Medicine & Rehabilitation

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423094400000",
    "number": "1043385206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 W MAIN STREET",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-269-6652",
            "fax_number": "631-269-6654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 W MAIN STREET",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-269-6652",
            "fax_number": "631-269-6654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET PHYSICAL THERAPY AND HAND REHABILITATION OF KINGS PARK, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2015-02-05",
        "status": "A",
        "authorized_official_last_name": "FONTANA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "631-269-6652",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "011230",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "0227181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Ann Lonardo, MA CCC-SLP
• Randie Jill London, PSY.D.
• John Charles Luna, LMSW
• Brandon Ryan Luoni
• Kathleen Mackenna, LCSW
• Marilyn P. Feeley
• Susan Margaret Marmorato
• Giuseppe M Massaro, PHARMD
• Nancy Mastromonica
• Colette A Matthews-Seaman, LCSW

• Physical Medicine & Rehabilitation Physician in Kings Park, NY
• Providers in Kings Park, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.