Individual provider Active NPI

Joseph Charles Kornahrens Jr., PT, DPT

  • Physical Therapist
  • Centereach, NY
National Provider Identifier
1104739937
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
056180 Issued in NY
Practice address
1500 Middle Country Rd
Centereach, NY 11720-3500
Phone
(631) 543-1440
Fax
(631) 543-1930
NPI assigned
Sep 23, 2026
Last updated
Sep 23, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 056180 NY Primary

Addresses

Primary practice location

1500 Middle Country Rd
Centereach, NY 11720-3500

Mailing address

1500 Middle Country Rd
Centereach, NY 11720-3500
Phone (631) 543-1440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790121600000",
    "number": "1104739937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 MIDDLE COUNTRY RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203500",
            "telephone_number": "631-543-1440",
            "fax_number": "631-543-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 MIDDLE COUNTRY RD",
            "city": "CENTEREACH",
            "state": "NY",
            "postal_code": "117203500",
            "telephone_number": "631-543-1440",
            "fax_number": "631-543-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNAHRENS",
        "first_name": "JOSEPH",
        "middle_name": "CHARLES",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-23",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "056180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centereach, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.