Professional Orthopedic And Sports Physical Therapy, P.C.
Physical Therapist in Port Jefferson Station, NY. Organization (NPI-2).
Details
- NPI
- 1376910554
- Entity type
- Organization (NPI-2)
- Legal business name
- Professional Orthopedic And Sports Physical Therapy, P.C.
- Organization subpart
- No
- Enumeration date
- Aug 24, 2015
- Last updated
- Mar 29, 2018
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
Practice location
5380 Nesconset HwyPort Jefferson Station, NY 11776-2056
Phone 631-474-4096 · Fax 631-474-5299
Mailing address
576 Broadhollow RdMelville, NY 11747-5002
Phone 631-359-5859 · Fax 631-396-0865
Authorized official
Leticia Pabellon
Vp Of Admin. Operations
5163212447
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 27 Physical Therapist providers in Port Jefferson Station · All 1,186 providers in Port Jefferson Station
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