| Agewell Physical Therapy And Wellness, P.c. | |
|
1999 Marcus Ave, Suite M15, Lake Success, NY 11042-1013 | |
| (516) 488-8808 | |
| (516) 488-8818 |
| Full Name | Agewell Physical Therapy And Wellness, P.c. |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 1999 Marcus Ave, Lake Success, New York |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861485070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 0155321 (New York) | Primary |
| Provider Name | Dimitrios Kostopoulos |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801834734 PECOS PAC ID: 9739164856 Enrollment ID: I20040624000034 |
| Provider Name | John Dragan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699729590 PECOS PAC ID: 8820062672 Enrollment ID: I20040825001611 |
| Provider Name | Mark A Herbrich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619922952 PECOS PAC ID: 6608840467 Enrollment ID: I20040825001719 |
| Provider Name | Inderjit S Kainth |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558791210 PECOS PAC ID: 0345479440 Enrollment ID: I20140213001051 |
| Provider Name | Ann P Hefferon Kilcarr |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528193356 PECOS PAC ID: 5698998425 Enrollment ID: I20140524000014 |
| Provider Name | Milena Alicandro |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437395001 PECOS PAC ID: 9234456518 Enrollment ID: I20150325001911 |
| Mailing Address | Practice Location Address |
|---|---|
| Agewell Physical Therapy And Wellness, P.c. 1999 Marcus Ave, Suite M15, Lake Success, NY 11042-1013 Ph: (516) 488-8808 | Agewell Physical Therapy And Wellness, P.c. 1999 Marcus Ave, Suite M15, Lake Success, NY 11042-1013 Ph: (516) 488-8808 |
Joan B Monaghan, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2800 Marcus Avenue, Suite 101, Lake Success, NY 11040 Phone: 516-622-6161 Fax: 516-622-6171 | |
Lyonel De Sagun, Physical Therapist Medicare: Medicare Enrolled Practice Location: 1979 Marcus Ave, Suite 204, Lake Success, NY 11042 Phone: 516-327-4681 | |
Agewell Diagnostics, Inc. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1999 Marcus Avenue, Suite M15, Lake Success, NY 11042 Phone: 516-488-8808 Fax: 516-488-8808 | |
Maricel De Vera, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1979 Marcus Ave, Suite 204, Lake Success, NY 11042 Phone: 516-327-4681 | |
Mark Alan Herbrich, P.T., M.A. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1999 Marcus Ave, Suite M15, Lake Success, NY 11042 Phone: 516-488-8808 Fax: 516-488-8818 | |
John J Dragan, P.T., GCS Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 1999 Marcus Ave, Suite M15, Lake Success, NY 11042 Phone: 516-488-8808 Fax: 516-488-8818 | |
Miss Maria C R Baltasar, PHYSICAL THERAPIST Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1979 Marcus Ave, Suite 204, Lake Success, NY 11042 Phone: 516-327-4681 |