Deer Park Physical Therapy & Chiropractic

Primary specialty

SpecialistTaxonomy code 174400000X

License

021022-1 Issued in NY

Legal business name

DEER PARK PHYSICAL THERAPY & CHIROPRACTIC

Practice address

2103 Deer Park Ave
Deer Park, NY 11729-1319

Phone

(631) 242-4500

Fax

(631) 242-0885

NPI assigned

Sep 16, 2014

Last updated

Sep 16, 2014By 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

Ronald Bredow, MS, PT

Title

Physical Therapy, Owner

Phone

(516) 315-2010

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1410825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410825600000",
    "number": "1750782256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291319",
            "telephone_number": "631-242-4500",
            "fax_number": "631-242-0885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 DEER PARK AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117291319",
            "telephone_number": "631-242-4500",
            "fax_number": "631-242-0885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER PARK PHYSICAL THERAPY & CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-16",
        "last_updated": "2014-09-16",
        "status": "A",
        "authorized_official_last_name": "BREDOW",
        "authorized_official_first_name": "RONALD",
        "authorized_official_title_or_position": "PHYSICAL THERAPY, OWNER",
        "authorized_official_telephone_number": "516-315-2010",
        "authorized_official_credential": "MS, PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "021022-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deer Park Chiropractic and Physical Therapy PLLC
• Deer Park Chiropractic PC (PTDC Chiropractic)
• Deer Park Fire District 14 Inc
• Deer Park Medical, P.C.
• Deer Park Medical, P.C.
• Deer Park Physical Therapy and Chiropractic PLLC
• Deer Park PT & Pta Physical Therapy & Rehabilitation, PLLC (Deer Park Physical Therapy & Rehabilitation)
• Deer Park PT, Family Health NP and Chiropractic PLLC (Deer Park PTDC)
• Deer Park Ufsd
• Courtney Defeo, CASAC-T

• Specialist in Deer Park, NY
• Providers in Deer Park, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.