Organization Active NPI

Professional Orthopedic and Sports Physical Therapy PC

  • Physical Therapist
  • Commack, NY
National Provider Identifier
1235554890
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC
Practice address
66 Commack Rd
Suite 300
Commack, NY 11725-3405
Phone
(631) 486-5286
Fax
(631) 486-5287
NPI assigned
Feb 19, 2014
Last updated
Mar 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Authorized official

Name
Helen Agrelo
Title
SVP of Administrative Operations
Phone
(516) 321-2424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NY Primary

Addresses

Primary practice location

66 Commack Rd
Suite 300
Commack, NY 11725-3405

Mailing address

576 Broadhollow Rd
Melville, NY 11747-5002
Phone (516) 321-2400

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1235554890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "516-321-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 COMMACK RD",
            "address_2": "SUITE 300",
            "city": "COMMACK",
            "state": "NY",
            "postal_code": "117253405",
            "telephone_number": "631-486-5286",
            "fax_number": "631-486-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "AGRELO",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "SVP OF ADMINISTRATIVE OPERATIONS",
        "authorized_official_telephone_number": "516-321-2424"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; 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.