Professional Orthopedic and Sports Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC

Practice address

92 Broadway
Suite 102
Greenlawn, NY 11740-1328

Phone

(631) 262-7855

Fax

(631) 262-7854

NPI assigned

Feb 19, 2014

Organization subpart

No

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

Authorized official

Name

Helen Agrelo

Title

SVP of Administrative Operations

Phone

(516) 321-2400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1710302369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "516-321-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 BROADWAY",
            "address_2": "SUITE 102",
            "city": "GREENLAWN",
            "state": "NY",
            "postal_code": "117401328",
            "telephone_number": "631-262-7855",
            "fax_number": "631-262-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "AGRELO",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "SVP OF ADMINISTRATIVE OPERATIONS",
        "authorized_official_telephone_number": "516-321-2400"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magdalena Pomykol-Petryk, MD
• Leslie Marie Portillo, MA, LCAT, ATR-BC
• Trevor Tomesh Prashad, DO
• Premise Health of New York Medical, P.C (BAE Systems Greenlawn NY)
• Professional Occupational & Physical Therapy, PLLC
• Kerri Lyn Quail, RPA-C
• Rachel Saks Nutrition LLC
• Alyssa Rehm
• Jeanette M. Richardt, LCSW
• Tyler Riebl, MA

• Physical Therapist in Greenlawn, NY
• Providers in Greenlawn, 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 Mar 30, 2018; 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.