Lewis Ross Baeringer, D.P.T.

Individual provider Active NPI Physical Therapist · Farmingdale, NY

NPI 1720193451 · NPPES record last updated Oct 13, 2015

Key facts

NPI
1720193451
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
020417-1 (NY)
Practice address
218 Fulton St Apt 1C
Farmingdale, NY 11735-2541
Phone
(516) 694-1093
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
020417-1NYMDPhysical Therapist
020417NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 020417-1 NY Yes

Addresses

Primary practice location

218 Fulton St Apt 1C
Farmingdale, NY 11735-2541

Mailing address

15 Lever PL
Plainview, NY 11803-3703
Phone (516) 938-0955

Other providers in Farmingdale, NY

All providers in Farmingdale, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.