Professional Occupational & Physical Therapy, PLLC
Organization Active NPI Occupational Therapist · Hewlett, NY
NPI 1578093100 · NPPES record last updated Apr 2, 2018
Key facts
- NPI
- 1578093100
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Occupational Therapist 225X00000X
- Legal business name
- PROFESSIONAL OCCUPATIONAL & PHYSICAL THERAPY, PLLC
- Practice address
- 1465 Broadway
Hewlett, NY 11557-1426 - Phone
- (516) 374-4248
- Fax
- (516) 374-4258
- NPI assigned
- Jun 15, 2017
- Organization subpart
- No
Authorized official
- Name
- Kathleen Brush
- Title
- Credentialing Manager
- Phone
- (631) 359-5859
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160608000715 | NY | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 3779873401 |
Receives reassigned benefits from 513 practitioners This NPI is an additional NPI on the enrollment |
| O20180330000825 | NY | DME Supplier - Independently-Practicing Occupational Therapist |
3779873401 | Practice locations: Hewlett, NY |
National Provider Directory
- Tax ID family
- Grand View Urgent Care LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | |||
| Occupational Therapist |
225X00000X | Yes |
Addresses
Primary practice location
1465 Broadway
Hewlett, NY 11557-1426
Mailing address
576 Broadhollow Rd
Melville, NY 11747-5002
Phone (631) 359-5859
Other providers in Hewlett, NY
- Michelle Pinkhasova
- Rodel Villarosa Placino
- Miroslava Linett Pradella
- Precision Wellness NP in Adult Health
- Prine Health Medical Group, PLLC
- Professional Orthopedic and Sports Physical Therapy PC
- Progress in Motion Physical Therapy PLLC
- Prokhiy Counseling
- Lyudmila Prokhiy
- Prominent U LLC
All providers in Hewlett, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.