Optimum Life Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

OPTIMUM LIFE PHYSICAL THERAPY

Practice address

475 Front Street
Hempstead, NY 11550

Phone

(516) 505-9505

Fax

(516) 505-5202

NPI assigned

Jun 22, 2007

Last updated

Nov 5, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Victoria Demarco, PT

Title

Physical Therapist

Phone

(516) 505-9505

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1649476078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 FRONT STREET",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "11550",
            "telephone_number": "516-505-9505",
            "fax_number": "516-505-5202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 FRONT STREET",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "11550",
            "telephone_number": "516-505-9505",
            "fax_number": "516-505-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM LIFE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "DEMARCO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "516-505-9505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP",
            "identifier": "160906P",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "6698183",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Hempstead, NY
• Providers in Hempstead, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.