Innovative Physical Therapy of Long Island P.C.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

031561 Issued in NY

Legal business name

INNOVATIVE PHYSICAL THERAPY OF LONG ISLAND P.C.

Practice address

193 Jericho Tpke
Mineola, NY 11501-1702

Phone

(516) 747-2323

Fax

(516) 747-2305

NPI assigned

Jun 7, 2018

Organization subpart

No

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

Authorized official

Name

Yaniv Raich, DPTNPI 1356625305

Title

Owner, PT

Phone

(516) 747-2323

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

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

• Yaniv Raich, DPT

  • Physical Therapist
  • Mineola, NY
  • NPI 1356625305
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1528329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528329600000",
    "number": "1861985665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011702",
            "telephone_number": "516-747-2323",
            "fax_number": "516-747-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 JERICHO TPKE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115011702",
            "telephone_number": "516-747-2323",
            "fax_number": "516-747-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PHYSICAL THERAPY OF LONG ISLAND P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-07",
        "last_updated": "2018-06-07",
        "status": "A",
        "authorized_official_last_name": "RAICH",
        "authorized_official_first_name": "YANIV",
        "authorized_official_title_or_position": "OWNER, PT",
        "authorized_official_telephone_number": "516-747-2323",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "031561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wajiha Illyas, MD
• Sarah Im, DO
• Louis J Imbriano, M.D.
• Jenne Ingrassia, MD
• Kasey Lorraine Innamorato, PHYSICIAN ASSISTANT
• Integrative Cardiology, PLLC
• Integrative Pain Medicine PLLC
• International Orthopedics, Inc.
• Joseph Richard Ippolito, MD
• Momin Iqbal

• Physical Therapy Clinic/Center in Mineola, NY
• Providers in Mineola, 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 Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.