Ny Spine Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

016816-1 Issued in NY

Legal business name

NY SPINE PHYSICAL THERAPY

Practice address

475 E Main St
Suite 103-105
Patchogue, NY 11772-3121

Phone

(631) 447-6100

Fax

(631) 447-6126

NPI assigned

Jun 25, 2006

Last updated

Mar 14, 2008By 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

Mr. Wayne Victor Hatami, PTNPI 1144253998

Title

Owner

Phone

(631) 447-6100

Specialties & licenses 1

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wayne Victor Hatami, PT

  • Physical Therapy Clinic/Center
  • Patchogue, NY
  • NPI 1144253998
  Authorized official Same address or phone
• Blake Holland, DPT

  • Physical Therapist
  • Patchogue, NY
  • NPI 1922023514
  NPD (past)
• William Keltz, DPT

  • Physical Therapist
  • Patchogue, NY
  • NPI 1649295213
  NPD (past)
• Keith James Kroll, PTA

  • Physical Therapy Assistant
  • Whitestone, NY
  • NPI 1518123587
  NPD (past)
• Daniel Michael Mondiello, DPT

  • Physical Therapist
  • Patchogue, NY
  • NPI 1760407340
  NPD (past)

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1831125327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 E MAIN ST",
            "address_2": "SUITE 103-105",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723121",
            "telephone_number": "631-447-6100",
            "fax_number": "631-447-6126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 E MAIN ST",
            "address_2": "SUITE 103-105",
            "city": "PATCHOGUE",
            "state": "NY",
            "postal_code": "117723121",
            "telephone_number": "631-447-6100",
            "fax_number": "631-447-6126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NY SPINE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "HATAMI",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-447-6100",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "016816-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Northport Vamc
• Jillian Nostro, DO
• John N Noveck, PA
• Kathleen Anne Nulty, LPN
• Ny Jamesport Acupuncture, PC
• Nyc Orthopedic and Spine, P.C.
• NYU Langone Hospitals (NYU Langone Hospitals - Suffolk)
• NYU Langone Hospitals (Long Island Community Hospital)
• NYU Langone Hospitals (NYU Langone Hospital - Suffolk)
• NYU Langone Hospitals (Brookhaven Memorial Hospital Hospice)

• Physical Therapy Clinic/Center in Patchogue, NY
• Providers in Patchogue, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.