Active NPI
Maureen Godfrey
- Physical Therapist
- Port Jefferson, NY
National Provider Identifier
1740684745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 014699
- Practice address
- 75 N Country Rd
Port Jefferson, NY 11777-2119 - Phone
- (631) 686-7648
- NPI assigned
- Oct 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 014699 | NY | Primary |
Addresses
Primary practice location
75 N Country Rd
Port Jefferson, NY 11777-2119
Mailing address
33 University Dr
East Setauket, NY 11733-1133
Phone (631) 675-9184
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014699 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413763200000",
"number": "1740684745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 UNIVERSITY DR",
"city": "EAST SETAUKET",
"state": "NY",
"postal_code": "117331133",
"telephone_number": "631-675-9184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 N COUNTRY RD",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772119",
"telephone_number": "631-686-7648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GODFREY",
"first_name": "MAUREEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-20",
"last_updated": "2014-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "014699",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Jefferson, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.