Patchogue Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

015188-1 Issued in NY

Legal business name

PATCHOGUE PHYSICAL THERAPY PC

Practice address

54 W Main St
Patchogue, NY 11772-3002

Phone

(631) 447-9211

Fax

(631) 447-9214

NPI assigned

Jul 31, 2006

Organization subpart

No

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

Authorized official

Name

Kieran Deneen, PTNPI 1619060613

Title

Co-President

Phone

(631) 447-9211

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kieran Gerard Deneen

  • Physical Therapist
  • Patchogue, NY
  • NPI 1619060613
  NPD (past) Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386659779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723002",
            "telephone_number": "631-447-9211",
            "fax_number": "631-447-9214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 W MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723002",
            "telephone_number": "631-447-9211",
            "fax_number": "631-447-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATCHOGUE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DENEEN",
        "authorized_official_first_name": "KIERAN",
        "authorized_official_title_or_position": "CO-PRESIDENT",
        "authorized_official_telephone_number": "631-447-9211",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "015188-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patchogue Fire Dept Ambulance Co Inc
• Patchogue Medical Group LLP
• Patchogue Medical Services, PC
• Patchogue Open MRI, PC
• Patchogue Pharmacy, Inc
• Patchogue Supermarkets LLC
• Patchogue Transportation Corp.
• Patchogue Urgent Care, P.C.
• Patchogue-Medford PT & Chiropractic PLLC
• Patchogue-Medford Ufsd

• 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 Aug 22, 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.