Active NPI
Laurel Pettit, DPT
- Physical Therapist
- Melville, NY
National Provider Identifier
1316586100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 031178
- Practice address
- 1895 Walt Whitman Rd
Melville, NY 11747-3031 - Phone
- (631) 577-3400
- Fax
- (631) 577-3409
- NPI assigned
- Dec 27, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 031178 | NY | Primary |
Addresses
Primary practice location
1895 Walt Whitman Rd
Melville, NY 11747-3031
Mailing address
1895 Walt Whitman Rd
Melville, NY 11747-3031
Phone (631) 577-3400
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 031178 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1577404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577404800000",
"number": "1316586100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1895 WALT WHITMAN RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117473031",
"telephone_number": "631-577-3400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1895 WALT WHITMAN RD",
"city": "MELVILLE",
"state": "NY",
"postal_code": "117473031",
"telephone_number": "631-577-3400",
"fax_number": "631-577-3409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTIT",
"first_name": "LAUREL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-27",
"last_updated": "2019-12-27",
"certification_date": "2019-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "031178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Melville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.