Interstate Physical Therapy & Massage PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

021889-1 Issued in NY

Legal business name

INTERSTATE PHYSICAL THERAPY & MASSAGE PLLC

Practice address

375 Main St
Islip, NY 11751-3521

Phone

(631) 224-4904

NPI assigned

Jan 28, 2008

Last updated

Jan 28, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Andrew Steven Zagorski, MSPT

Title

Owner

Phone

(631) 224-4904

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1427235852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 MAIN ST",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513521",
            "telephone_number": "631-224-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 MAIN ST",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513521",
            "telephone_number": "631-224-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE PHYSICAL THERAPY & MASSAGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "ZAGORSKI",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-224-4904",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "021889-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Islip, NY
• Providers in Islip, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.