Premier Physical Therapy Of Long Island Pc | |
1 Terry St, Patchogue, NY 11772-1720 | |
(111) 111-1111 | |
Not Available |
Full Name | Premier Physical Therapy Of Long Island Pc |
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Type | Facility |
Speciality | Physical Therapist |
Location | 1 Terry St, Patchogue, 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 |
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1528351988 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | 024794 (New York) | Primary |
Provider Name | Matthew D Angelillo |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1104868298 PECOS PAC ID: 8729085436 Enrollment ID: I20061021000005 |
Provider Name | Heather A Angelillo |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1205029956 PECOS PAC ID: 0345325403 Enrollment ID: I20080313000206 |
Mailing Address | Practice Location Address |
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Premier Physical Therapy Of Long Island Pc 84 Pacific Blvd, Long Beach, NY 11561-4700 Ph: (516) 698-2930 | Premier Physical Therapy Of Long Island Pc 1 Terry St, Patchogue, NY 11772-1720 Ph: (111) 111-1111 |
Ronald Amaya Lopez, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 322 W Main St, Patchogue, NY 11772 Phone: 631-228-4977 | |
Sungguk Bae, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 21 Cleveland St, Patchogue, NY 11772 Phone: 631-569-9373 | |
Nicole Marie Divirgilio, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 77 Route 112 Ste F, Patchogue, NY 11772 Phone: 631-207-2370 | |
John Lowe Wilson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 25 Theresa Ct, Patchogue, NY 11772 Phone: 631-730-3326 | |
Danielle M Bousquet, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 77 Medford Ave, Patchogue, NY 11772 Phone: 631-758-1910 | |
Stephanie Lauren Vanschaick, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 77 Medford Ave, Patchogue, NY 11772 Phone: 631-758-1910 Fax: 631-758-1984 | |
Kathleen Alyssa Bailey, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 322 W Main St, Patchogue, NY 11772 Phone: 631-228-4977 |