P.T.C Medical, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

P.T.C MEDICAL, P.C.

Practice address

79 E Main St
Patchogue, NY 11772-3101

Phone

(631) 289-0088

Fax

(631) 289-6177

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Paolo Thomas Coppola, MD

Title

DC

Phone

(631) 289-0088

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1740360130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 E MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723101",
            "telephone_number": "631-289-0088",
            "fax_number": "631-289-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 E MAIN ST",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723101",
            "telephone_number": "631-289-0088",
            "fax_number": "631-289-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P.T.C MEDICAL, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "COPPOLA",
        "authorized_official_first_name": "PAOLO",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "DC",
        "authorized_official_telephone_number": "631-289-0088",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Barbara Pagliaro, CASAC
• Gregory Steven Pahlavi, PA-C
• Diana Palladino, RN
• Jamie Palm, LMHC, CRC

• Physical Medicine & Rehabilitation Physician in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Physical Medicine & Rehabilitation Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.