Reardon Physical Therapy, PLLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

036545 Issued in NY

Legal business name

REARDON PHYSICAL THERAPY, PLLC

Practice address

4 Cedar Ave
Islip, NY 11751-3802

Phone

(631) 647-0523

Fax

(631) 870-0294

NPI assigned

Oct 29, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Gregory Reardon, DPT, CSCSNPI 1407274145

Title

Owner

Phone

(631) 647-0523

Specialties & licenses 1

Addresses

Other names 1

• PREP Physio Therapy Doing business as

Locations

Practitioners 1

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

• Gregory Reardon, DPT, CSCS

  • Physical Therapist
  • Manhasset, NY
  • NPI 1407274145
  NPD Authorized official

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

{
    "created_epoch": "1509235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509235200000",
    "number": "1699287789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 HANCOCK RD",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117951738",
            "telephone_number": "631-926-5907",
            "fax_number": "631-926-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CEDAR AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513802",
            "telephone_number": "631-647-0523",
            "fax_number": "631-870-0294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REARDON PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-29",
        "last_updated": "2017-10-29",
        "status": "A",
        "authorized_official_last_name": "REARDON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-647-0523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT, CSCS"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NY",
            "license": "036545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PREP Physio Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopedic Physical Therapist in Islip, NY
• Providers in Islip, NY by specialty
• Orthopedic Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2017; 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.