Professional Orthopedic and Sports Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

028766 Issued in NY

Legal business name

PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC

Practice address

121 Broadhollow Rd
Melville, NY 11747-4906

Phone

(631) 354-5600

Fax

(631) 425-1020

NPI assigned

Jan 19, 2012

Last updated

Mar 30, 2018By 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

Helen Agrelo

Title

SVP of Administrative Operations

Phone

(516) 321-2424

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1326931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1821369026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117475002",
            "telephone_number": "718-767-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BROADHOLLOW RD",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474906",
            "telephone_number": "631-354-5600",
            "fax_number": "631-425-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ORTHOPEDIC AND SPORTS PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-19",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "AGRELO",
        "authorized_official_first_name": "HELEN",
        "authorized_official_title_or_position": "SVP OF ADMINISTRATIVE OPERATIONS",
        "authorized_official_telephone_number": "516-321-2424"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "028766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Melville, NY
• Providers in Melville, 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 Mar 30, 2018; 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.