L.I. Pro Physical Therapy P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

031214-1 Issued in NY

Legal business name

L.I. PRO PHYSICAL THERAPY P.C.

Practice address

11 Canby CT
West Islip, NY 11795-2309

Phone

(631) 873-6100

NPI assigned

Jan 17, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Justin Andrew Minerva, DPTNPI 1124324942

Title

Owner

Phone

(631) 873-6100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Justin Andrew Minerva, DPT

  • Physical Therapist
  • West Islip, NY
  • NPI 1124324942
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1104164656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CANBY CT",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952309",
            "telephone_number": "631-873-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 CANBY CT",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117952309",
            "telephone_number": "631-873-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "L.I. PRO PHYSICAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "MINERVA",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-873-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "031214-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kuang
• Ashok Navit Kukadia, MD
• Anand Kumar, PHYSICIAN ASSISTANT
• Urbashi Kumari
• Roshan Varghese Kurien, PA-C
• Noelle Lacroix, DVM
• Christopher James Lafferty, M.D.
• Melissa Ann Laino, LPN
• Genevieve Lambert, M.D.
• Robert J Landy, D.P.M.

• Physical Therapist in West Islip, NY
• Providers in West Islip, 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 Jan 17, 2013; 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.