Optimum Performance Physical Therapy & Training, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

0183841 Issued in NY

Legal business name

OPTIMUM PERFORMANCE PHYSICAL THERAPY & TRAINING, PLLC

Practice address

4217 Merrick Rd
Massapequa, NY 11758-6015

Phone

(516) 765-1637

Fax

(516) 977-0799

NPI assigned

Jul 28, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Scott Radomski, PT

Title

Owner

Phone

(516) 765-1637

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248739200000",
    "number": "1366673162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MONROE ST",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622423",
            "telephone_number": "516-765-1637",
            "fax_number": "516-977-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4217 MERRICK RD",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586015",
            "telephone_number": "516-765-1637",
            "fax_number": "516-977-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PERFORMANCE PHYSICAL THERAPY & TRAINING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-28",
        "last_updated": "2009-07-28",
        "status": "A",
        "authorized_official_last_name": "RADOMSKI",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-765-1637",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "0183841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2009; 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.