Premier Performance Physical Therapy PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

027611 Issued in NY

Legal business name

PREMIER PERFORMANCE PHYSICAL THERAPY PC

Practice address

90 Hewlett Avenue
Point Lookout, NY 11569

Phone

(516) 608-9298

NPI assigned

Jan 8, 2009

Organization subpart

No

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

Authorized official

Name

Rory Maguire Primrose

Title

President

Phone

(516) 608-9298

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1144467564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HEWLETT AVE",
            "address_2": "PO BOX 327",
            "city": "POINT LOOKOUT",
            "state": "NY",
            "postal_code": "11569",
            "telephone_number": "516-608-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HEWLETT AVENUE",
            "city": "POINT LOOKOUT",
            "state": "NY",
            "postal_code": "11569",
            "telephone_number": "516-608-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PERFORMANCE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "PRIMROSE",
        "authorized_official_first_name": "RORY",
        "authorized_official_middle_name": "MAGUIRE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-608-9298"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "027611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Point Lookout, NY
• Providers in Point Lookout, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.