NPIMap

Organization Active NPI

Lifelong Rehab Enterprises

  • Physical Therapist
  • East Quogue, NY
National Provider Identifier
1245855519
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LIFELONG REHAB ENTERPRISES
Practice address
143 Chardonnay Dr
East Quogue, NY 11942-3829
Phone
(631) 278-0665
Fax
(631) 532-4886
NPI assigned
Jun 12, 2020
Last updated
Jun 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Authorized official

Name
Mr. Jeffrey Ciolino, OTRNPI 1144247222
Title
President
Phone
(631) 278-0665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

143 Chardonnay Dr
East Quogue, NY 11942-3829

Mailing address

143 Chardonnay Dr
East Quogue, NY 11942-3829
Phone (631) 278-0665

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591920000000",
    "number": "1245855519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 CHARDONNAY DR",
            "city": "EAST QUOGUE",
            "state": "NY",
            "postal_code": "119423829",
            "telephone_number": "631-278-0665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 CHARDONNAY DR",
            "city": "EAST QUOGUE",
            "state": "NY",
            "postal_code": "119423829",
            "telephone_number": "631-278-0665",
            "fax_number": "631-532-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG REHAB ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A",
        "authorized_official_last_name": "CIOLINO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-278-0665",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Quogue, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.