Active NPI
Leisure Physical Therapy PC
- Physical Therapist
- Wading River, NY
National Provider Identifier
1083884944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 016275-1
- Legal business name
- LEISURE PHYSICAL THERAPY PC
- Practice address
- 6144 Route 25a Ste 13
Wading River, NY 11792-2008 - Phone
- (631) 804-9410
- Fax
- (631) 345-8919
- NPI assigned
- Mar 6, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Scott Paskiewicz, PT
- Title
- President
- Phone
- (631) 804-9410
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 016275-1 | NY | Primary |
Addresses
Primary practice location
6144 Route 25a Ste 13
Wading River, NY 11792-2008
Mailing address
6 Sweetberry Ave
Center Moriches, NY 11934-1417
Phone (631) 804-9410
Other practice location 1
10 Roosevelt Ave
Port Jefferson Station, NY 11776-3393
Phone (631) 804-9410
National Provider Directory
National Provider DirectoryLocations
11 Roosevelt Ave
Port Jefferson Station, NY 11776
6144 Route 25A
Ste 2
Wading River, NY 11792
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Electrophysiology Physical Therapist
- Columbus, GA
- NPI 1396886529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204761600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1689033600000",
"number": "1083884944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 SWEETBERRY AVE",
"city": "CENTER MORICHES",
"state": "NY",
"postal_code": "119341417",
"telephone_number": "631-804-9410",
"fax_number": "631-821-8366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6144 ROUTE 25A STE 13",
"city": "WADING RIVER",
"state": "NY",
"postal_code": "117922008",
"telephone_number": "631-804-9410",
"fax_number": "631-345-8919"
}
],
"practiceLocations": [
{
"address_1": "10 Roosevelt Ave",
"address_purpose": "LOCATION",
"city": "Port Jefferson Station",
"state": "NY",
"postal_code": "117763393",
"country_code": "US",
"telephone_number": "631-804-9410",
"fax_number": "631-345-8919",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LEISURE PHYSICAL THERAPY PC",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-06",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A",
"authorized_official_last_name": "PASKIEWICZ",
"authorized_official_first_name": "SCOTT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "631-804-9410",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "NY",
"license": "016275-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wading River, NY
- Aaron William Krebo, RN
- L.C. Nurse Practitioner in Adult Health Services PLLC
- Bridget Laux, LMT
- Maxine Marie Lee, RN
- Juliet Jean Lehman, OTR
- Courtney Danielle Lewis
- Lite Step Podiatry Wellness PC
- Lite Step Podiatry Wellness, PC
- Little Flower & Children & Family Services
- Little Flower Children & Family Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.