Distinctive Physical Therapy PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

029447 Issued in NY

Legal business name

DISTINCTIVE PHYSICAL THERAPY PLLC

Practice address

1545 Walnut Ave
Merrick, NY 11566-2218

Phone

(516) 214-8307

Fax

(516) 750-9086

NPI assigned

Dec 3, 2009

Organization subpart

No

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

Authorized official

Name

Michael C Zagare, PT

Title

Physician

Phone

(516) 214-8307

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1259798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284422400000",
    "number": "1790013746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 WALNUT AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115662218",
            "telephone_number": "516-214-8307",
            "fax_number": "516-750-9086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 WALNUT AVE",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115662218",
            "telephone_number": "516-214-8307",
            "fax_number": "516-750-9086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-03",
        "last_updated": "2010-09-14",
        "status": "A",
        "authorized_official_last_name": "ZAGARE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "516-214-8307",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Merrick, NY
• Providers in Merrick, 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 Sep 14, 2010; 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.