NPIMap

Organization Active NPI

PRN Physical Therapy PC

  • Physical Therapist
  • Holbrook, NY
National Provider Identifier
1528096302
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
016663 Issued in NY
Legal business name
PRN PHYSICAL THERAPY PC
Practice address
20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone
(631) 467-3700
Fax
(631) 467-0928
NPI assigned
Jun 29, 2006
Last updated
Mar 8, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Authorized official

Name
Mr. Stephen Joseph, PTNPI 1063497717
Title
President
Phone
(631) 467-3700

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 016663 NY Primary

Addresses

Primary practice location

20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616

Mailing address

20 Peachtree CT
Suite 105
Holbrook, NY 11741-4616
Phone (631) 467-3700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1151539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615161600000",
    "number": "1528096302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 105",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-467-3700",
            "fax_number": "631-467-0928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRN PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-29",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-467-3700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "016663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; 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.