Bay Shore Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0151101 Issued in NY

Legal business name

BAY SHORE PHYSICAL THERAPY

Practice address

1590 Union Blvd
Bay Shore, NY 11706

Phone

(631) 665-2421

Fax

(631) 665-3416

NPI assigned

Nov 17, 2006

Last updated

Jun 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nick Porillico, PT

Title

President

Phone

(631) 665-2421

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kieran Gerard Deneen

  • Physical Therapist
  • Patchogue, NY
  • NPI 1619060613
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1740353481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-665-2421",
            "fax_number": "631-665-3416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 UNION BLVD",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "11706",
            "telephone_number": "631-665-2421",
            "fax_number": "631-665-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY SHORE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "PORILLICO",
        "authorized_official_first_name": "NICK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-665-2421",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "0151101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bay Shore Family Medicine Associates, P.C.
• Bay Shore Medical Healthcare PC
• Bay Shore Medical Services, P.C.
• Bay Shore OB GYN Group PC
• Bay Shore Physical Medicine &Rehabilitation
• Bay Shore Ufsd
• Bay Shore Union Free School District
• Bayshore Chiropractic PC
• Bayshore Eyecare LLC (Sterling Optical)
• Bayshore Home Healthcare, Inc .

• Physical Therapist in Bay Shore, NY
• Providers in Bay Shore, 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 Jun 11, 2008; 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.