Loretta Marie Peck, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

024471 Issued in NY

Practice address

199 Orchard Rd
East Patchogue, NY 11772-5510

Phone

(631) 742-4282

NPI assigned

Nov 13, 2007

Last updated

May 15, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Life PT Online, P.L.L.C.

  • Physical Therapist
  • East Patchogue, NY
  • NPI 1649893603
  NPD Authorized official

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1699955146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 ORCHARD RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725510",
            "telephone_number": "631-742-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 ORCHARD RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725510",
            "telephone_number": "631-742-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "LORETTA",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "024471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitul R Patel, M.D.
• Nalinikant K. Patel, M.D.
• Preeya Patel
• Brooke Patterson, PT, DPT
• Joseph Michael Patti, RPA-C
• Heather Penny, RN
• Christopher Perniciaro, HIS
• Terry Picard
• Grace Piechnik, MA, BCBA, LBA
• Michaelle Pierre, LPN

• Physical Therapist in East Patchogue, NY
• Providers in East Patchogue, 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 May 15, 2020; 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.