| Jefferson Sports & Physical Therapy, Pc | |
|
460 County Road 111, #15, Manorville, NY 11949 | |
| (631) 909-8712 | |
| (631) 909-8714 |
| Full Name | Jefferson Sports & Physical Therapy, Pc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 460 County Road 111, Manorville, 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 |
|---|---|---|---|
| 1407083686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 007458 (New York) | Primary |
| Provider Name | Brian J Heim |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033168687 PECOS PAC ID: 2567509953 Enrollment ID: I20091016000027 |
| Provider Name | Thomas Alan Derosa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396005518 PECOS PAC ID: 5092967497 Enrollment ID: I20121211000463 |
| Provider Name | Matthew Thomas Heim |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760874812 PECOS PAC ID: 8123346871 Enrollment ID: I20150409001848 |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Sports & Physical Therapy, Pc 460 County Road 111, #15, Manorville, NY 11949 Ph: (631) 909-8712 | Jefferson Sports & Physical Therapy, Pc 460 County Road 111, #15, Manorville, NY 11949 Ph: (631) 909-8712 |
Joan Dash, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5 Tee View Ct, Manorville, NY 11949 Phone: 631-874-3032 Fax: 631-874-4105 | |
Risa Halpern, PT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 5 Tee View Ct, Manorville, NY 11949 Phone: 631-874-3032 | |
Patricia Cooney, Physical Therapist Medicare: Medicare Enrolled Practice Location: 5 Tee View Ct, Manorville, NY 11949 Phone: 631-874-3032 Fax: 631-874-4105 | |
Lisa M Smith, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 33 Foreston Cir, Manorville, NY 11949 Phone: 631-874-9198 Fax: 631-792-1103 | |
Alexandra Galiano-presti, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5 Tee View Ct, Manorville, NY 11949 Phone: 631-874-3032 Fax: 631-874-4105 | |
Mr. Christopher Michael Gallagher, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4 Old Neck Ct, Manorville, NY 11949 Phone: 631-874-0282 | |
Kristin Votteler, P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 221 N Sunrise Service Rd, Manorville, NY 11949 Phone: 631-878-8900 |