Provident Physical and Occupational Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROVIDENT PHYSICAL AND OCCUPATIONAL THERAPY PLLC

Practice address

554 Larkfield Rd Ste 207
East Northport, NY 11731-4205

Phone

(631) 266-4501

Fax

(631) 266-4502

NPI assigned

Jul 7, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Steven C Desousa, PT, DPT, MA, OCSNPI 1457321911

Title

Owner/ PT

Phone

(631) 266-4501

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

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

• Steven C Desousa, PT

  • Physical Therapist
  • East Northport, NY
  • NPI 1457321911
  Medicare reassignment NPD Authorized official
• Mark Guzman, OTR/L

  • Occupational Therapist
  • Great Neck, NY
  • NPI 1003265620
  Medicare reassignment Care Compare group NPD
• Caitlin Sorrentino, OTR/L

  • Occupational Therapist
  • Monroe, NY
  • NPI 1740721513
  Medicare reassignment Care Compare group
• Robyn Marsden

  • Occupational Therapist
  • Highland Mills, NY
  • NPI 1922545938
  NPD
• Ann Marie Pittelli, OTR/L

  • Gerontology Occupational Therapist
  • Huntington, NY
  • NPI 1679805444
  NPD (past)

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499385600000",
    "number": "1144742479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD STE 207",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "631-266-4501",
            "fax_number": "631-266-4502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 LARKFIELD RD STE 207",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117314205",
            "telephone_number": "631-266-4501",
            "fax_number": "631-266-4502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT PHYSICAL AND OCCUPATIONAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2017-07-07",
        "status": "A",
        "authorized_official_last_name": "DESOUSA",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/ PT",
        "authorized_official_telephone_number": "631-266-4501",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, DPT, MA, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Roger Poudrier, DPT
• Milan Poukamissas
• Michele Preiser
• Kayla Marie Price
• Danielle Marie Profaci
• Debra Noelle Puca
• Bryan William Purcell
• Michael R Quigg, CPO
• Gigi Quiocho
• Zille Huma Qureshi, RPH

• Physical Therapist in East Northport, NY
• Providers in East 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 Jul 7, 2017; 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.