NPIMap

Organization Active NPI

Montefiore Medical Center

  • Physical Therapist
  • East Patchogue, NY
National Provider Identifier
1104649292
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MONTEFIORE MEDICAL CENTER
Practice address
655 E Montauk Hwy Ste 23
East Patchogue, NY 11772-3154
Phone
(631) 456-5512
Fax
(631) 456-5514
NPI assigned
Nov 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
John M Preolo
Title
Senior Director Provider Credential
Phone
(914) 608-5063

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

655 E Montauk Hwy Ste 23
East Patchogue, NY 11772-3154

Mailing address

100 Corporate Dr Ste 100
Yonkers, NY 10701-6807
Phone (914) 378-6148

Other names 1

  • Access PT East Patchogue Other name

National Provider Directory

National Provider Directory
Tax ID family
Peter Marcus519 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

655 E Montauk Hwy
Ste 23
East Patchogue, NY 11772
Phone (516) 741-3338

NPI Registry JSON

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

{
    "created_epoch": "1730851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1104649292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CORPORATE DR STE 100",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107016807",
            "telephone_number": "914-378-6148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E MONTAUK HWY STE 23",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117723154",
            "telephone_number": "631-456-5512",
            "fax_number": "631-456-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEFIORE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-06",
        "last_updated": "2025-07-07",
        "certification_date": "2025-07-07",
        "status": "A",
        "authorized_official_last_name": "PREOLO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SENIOR DIRECTOR PROVIDER CREDENTIAL",
        "authorized_official_telephone_number": "914-608-5063"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Access PT East Patchogue",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Access PT East Patchogue",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Patchogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2025; 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.