NPIMap

Organization Active NPI

Connetquot PT & Chiropractic PLLC

Doing business as Connetquot PTDC

  • Physical Therapist
  • Ronkonkoma, NY
National Provider Identifier
1467980771
Registry record updated May 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CONNETQUOT PT & CHIROPRACTIC PLLC
Doing business as
Connetquot PTDC
Practice address
2805 Veterans Hwy
Ronkonkoma, NY 11779-7647
Phone
(631) 738-9539
Fax
(631) 738-8500
NPI assigned
May 31, 2017
Last updated
May 31, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2017

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

Authorized official

Name
Jack TesorieroNPI 1871580282
Title
Owner/Chiropractor
Phone
(631) 738-9539

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X
Physical Therapist 225100000X Primary

Addresses

Primary practice location

2805 Veterans Hwy
Ronkonkoma, NY 11779-7647

Mailing address

2103 Deer Park Ave
Deer Park, NY 11729-1317
Phone (631) 242-4500

Other names 1

  • Connetquot PTDC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496188800000",
    "number": "1467980771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291317",
            "telephone_number": "631-242-4500",
            "fax_number": "631-242-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 VETERANS HWY",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797647",
            "telephone_number": "631-738-9539",
            "fax_number": "631-738-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNETQUOT PT & CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-31",
        "last_updated": "2017-05-31",
        "status": "A",
        "authorized_official_last_name": "TESORIERO",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "631-738-9539"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Connetquot PTDC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ronkonkoma, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2017; 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.