Long Island Sports & Rehabilitation Center East, Co.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

00587-1 Issued in NY

Legal business name

LONG ISLAND SPORTS & REHABILITATION CENTER EAST, CO.

Practice address

4800 Veterans Hwy
Holbrook, NY 11741-4512

Phone

(631) 563-8400

Fax

(631) 589-5582

NPI assigned

Jul 19, 2007

Organization subpart

No

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

Authorized official

Name

Lois Cloud-Malenczak, M.A.P.T.NPI 1780619429

Title

Director

Phone

(631) 563-8400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

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

• Lois Cloud Malenczak, P.T.

  • Physical Therapist
  • Bohemia, NY
  • NPI 1780619429
  Medicare reassignment Care Compare group NPD Authorized official
• Michelle Katherine Buderman, DPT

  • Physical Therapist
  • Holbrook, NY
  • NPI 1932334240
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633392000000",
    "number": "1063612943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 VETERANS HWY",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414512",
            "telephone_number": "631-563-8400",
            "fax_number": "631-589-5582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 VETERANS HWY",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414512",
            "telephone_number": "631-563-8400",
            "fax_number": "631-589-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND SPORTS & REHABILITATION CENTER EAST, CO.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A",
        "authorized_official_last_name": "CLOUD-MALENCZAK",
        "authorized_official_first_name": "LOIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-563-8400",
        "authorized_official_credential": "M.A.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "00587-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa M. Cassidy, Psychology, P.C.
• Qun Liu
• Jean Paul Lo
• Samantha Ann Locascio-Egbert, MS, CCC-SLP, TSSLD
• Ashley Lombardo
• Chris Patrick Longo
• Kristine Longo, RN
• Alexander Lopez, P.T.
• Julianne L Lopreto, MSED
• Lotus Medical Management, LLC

• Physical Therapy Clinic/Center in Holbrook, NY
• Providers in Holbrook, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.