Donna Boughal

Individual provider Active NPI Physical Therapy Assistant · Westhampton Beach, NY

NPI 1497159727 · NPPES record last updated Oct 15, 2014

Key facts

NPI
1497159727
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
005535-1 (NY)
Practice address
74 Old Riverhead Rd
Westhampton Beach, NY 11978-1401
Phone
(631) 288-7767
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005535-1NYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 005535-1 NY Yes

Addresses

Primary practice location

74 Old Riverhead Rd
Westhampton Beach, NY 11978-1401

Mailing address

74 Old Riverhead Rd
Westhampton Beach, NY 11978-1401

Other providers in Westhampton Beach, NY

All providers in Westhampton Beach, NY · Physical Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.