NPIMap

Organization Active NPI

New York Physical and Occupational Therapy PLLC

Doing business as Proform Physical Therapy

  • Physical Therapy Clinic/Center
  • Smithtown, NY
National Provider Identifier
1881614295
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Doing business as
Proform Physical Therapy
Practice address
317 Middle Country Road
Suite # 3
Smithtown, NY 11787
Phone
(631) 361-9246
Fax
(888) 215-5091
NPI assigned
Jul 20, 2006
Organization subpart
Yes
Parent organization
NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Ms. Irene Delpercio
Title
Operations Manager
Phone
(631) 665-8645

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

317 Middle Country Road
Suite # 3
Smithtown, NY 11787

Mailing address

569 E Main Street
Bayshore, NY 11706-8505
Phone (631) 665-8645

Other names 1

  • Proform Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Frederick J Burke10 organizations share this tax ID, including this one
Part of
Frederick J Burke

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

317 E Middle Country Rd
Ste 3
Smithtown, NY 11787
Phone (631) 361-9246

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1881614295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "569 E MAIN STREET",
            "city": "BAYSHORE",
            "state": "NY",
            "postal_code": "117068505",
            "telephone_number": "631-665-8645",
            "fax_number": "631-665-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 MIDDLE COUNTRY ROAD",
            "address_2": "SUITE # 3",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "11787",
            "telephone_number": "631-361-9246",
            "fax_number": "888-215-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NEW YORK PHYSICAL AND OCCUPATIONAL THERAPY PLLC",
        "enumeration_date": "2006-07-20",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "DELPERCIO",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "631-665-8645",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proform Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.