Audra Lynn Arestivo, PT
Individual provider Active NPI Physical Therapist · Northport, NY
NPI 1720114895 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720114895
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 011208-1 (NY)
- Practice address
- 18 Sheffield LN
Northport, NY 11768-3248 - Phone
- (631) 757-0948
- Fax
- (631) 757-0948
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011208-1 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 011208-1 | NY | Yes |
Addresses
Primary practice location
18 Sheffield LN
Northport, NY 11768-3248
Mailing address
18 Sheffield LN
Northport, NY 11768-3248
Phone (631) 757-0948
Other providers in Northport, NY
- Morgan Anderson
- Lisa Angadi
- Jennifer Angelopoulos
- Cindy Panza Ansink
- Kathleen Araco
- Gabriella Argyros
- Ari Medical, PC
- Joselito Arias
- Kathleen Armstrong-Macleod
- Vernon Ray Arthur
All providers in Northport, NY · Physical 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 Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.