NPIMap

Organization Active NPI

Three Village Physical Therapy PLLC

  • Physical Therapist
  • Stony Brook, NY
National Provider Identifier
1831260504
Registry record updated Nov 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
014253-1 Issued in NY
Legal business name
THREE VILLAGE PHYSICAL THERAPY PLLC
Practice address
97 Main St
Suite F
Stony Brook, NY 11790-1937
Phone
(631) 355-2120
Fax
(843) 686-4000
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2013

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

Authorized official

Name
Mr. Robert E Dayton, PT,CFMT
Title
President
Phone
(631) 355-2120

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 014253-1 NY Primary

Addresses

Primary practice location

97 Main St
Suite F
Stony Brook, NY 11790-1937

Mailing address

6 Outpost LN
Hilton Head Island, SC 29928-3802
Phone (631) 355-2120

Other names 1

  • THREE VILLAGE PHYSICAL THERAPY & FITNESS Doing business as

National Provider Directory

National Provider Directory

Locations

97 Main St
Ste F
Stony Brook, NY 11790
Phone (631) 355-2120

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384041600000",
    "number": "1831260504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 OUTPOST LN",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299283802",
            "telephone_number": "631-355-2120",
            "fax_number": "843-686-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 MAIN ST",
            "address_2": "SUITE F",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117901937",
            "telephone_number": "631-355-2120",
            "fax_number": "843-686-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE VILLAGE PHYSICAL THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2013-11-10",
        "status": "A",
        "authorized_official_last_name": "DAYTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-355-2120",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT,CFMT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "014253-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THREE VILLAGE PHYSICAL THERAPY & FITNESS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stony Brook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2013; 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.