Ejm Prestige Enterprise, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EJM PRESTIGE ENTERPRISE, LLC

Practice address

68 Eatons Neck Rd
Northport, NY 11768-1105

Phone

(516) 242-5799

NPI assigned

Mar 7, 2023

Last updated

May 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alex Meyerholz, DPTNPI 1972058246

Title

Ceo/Physical Therapist

Phone

(516) 242-5799

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alex Meyerholz

  • Physical Therapist
  • New York, NY
  • NPI 1972058246
  NPD Authorized official

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685404800000",
    "number": "1093415226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 EATONS NECK RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 EATONS NECK RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681105",
            "telephone_number": "516-242-5799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EJM PRESTIGE ENTERPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A",
        "authorized_official_last_name": "MEYERHOLZ",
        "authorized_official_first_name": "ALEX",
        "authorized_official_title_or_position": "CEO/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "516-242-5799",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leatrice Kiichelle Dyer, LPN
• Eating Disorder Treatment of New York, LLC (Clementine North Shore)
• Eatons Neck Fire District
• Bruce James Edington, LCSW-R
• Alex Egglinger
• Andrew Michael Ekelund, PT
• Basem Sadek Elfaham, M.D.
• Elizabeth Ann Haeni DPM PC
• Elizabeth Haeni DPM
• Tracey E Enright, MT-BC

• Physical Therapist in Northport, NY
• Providers in Northport, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.

Verify at the official NPI Registry.