Organization Active NPI

Long Island Physical Rehabilitation & Sports Medicine

  • Physical Medicine & Rehabilitation Physician
  • New Hyde Park, NY
National Provider Identifier
1487794640
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
191224 Issued in NY
Legal business name
LONG ISLAND PHYSICAL REHABILITATION & SPORTS MEDICINE
Practice address
444 Lakeville Rd
Suite 201
New Hyde Park, NY 11042-1165
Phone
(516) 326-1950
Fax
(516) 326-2950
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Monte A Haber, M.D.NPI 1669567202
Title
President
Phone
(516) 326-1950

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 191224 NY Primary

Addresses

Primary practice location

444 Lakeville Rd
Suite 201
New Hyde Park, NY 11042-1165

Mailing address

444 Lakeville Rd
Suite 201
New Hyde Park, NY 11042-1165
Phone (516) 326-1950

Other identifiers 1

IdentifierTypeStateIssuer
01777393MedicaidNY

National Provider Directory

National Provider Directory

Locations

444 Lakeville Rd
Ste 201
New Hyde Park, NY 11042
Phone (516) 326-1950

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487794640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 LAKEVILLE RD",
            "address_2": "SUITE 201",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421165",
            "telephone_number": "516-326-1950",
            "fax_number": "516-326-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 LAKEVILLE RD",
            "address_2": "SUITE 201",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421165",
            "telephone_number": "516-326-1950",
            "fax_number": "516-326-2950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND PHYSICAL REHABILITATION & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HABER",
        "authorized_official_first_name": "MONTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-326-1950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NY",
            "license": "191224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01777393",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hyde Park, NY

Sources for this page

  • 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.