Coastal Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

COASTAL PHYSICAL THERAPY

Practice address

38 Oak St Ste 2
Patchogue, NY 11772-2883

Phone

(631) 654-2225

NPI assigned

Jan 13, 2022

Organization subpart

No

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

Authorized official

Name

Russell Taveras

Title

Owner

Phone

(631) 654-2225

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642032000000",
    "number": "1346991114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 OAK ST STE 2",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722883",
            "telephone_number": "631-654-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 OAK ST STE 2",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117722883",
            "telephone_number": "631-654-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A",
        "authorized_official_last_name": "TAVERAS",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-654-2225"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary Cipolla, MA, OTR/L
• City Medical of Upper East Side, PLLC
• Cheyenne Nicole Clinkscales, PA-C
• William John Closson, PH.D.
• Coaching for Life
• Bridget Marie Colarusso, M.S.ED., CCC-SLP
• Cathy Coleman, M.D.
• Emily Colon
• Brian Connell, PT
• Devon Driscoll Connolly, PA-C

• Physical Therapist in Patchogue, NY
• Providers in Patchogue, 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 Jan 13, 2022; 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.