Nicole Brock
Physical Therapist in Massapequa Park, NY. Individual provider (NPI-1).
NPI number1376974774
StatusActive
Last updated in NPPESDec 10, 2013
Details
- NPI
- 1376974774
- Entity type
- Individual (NPI-1)
- Name
- Nicole Brock
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 10, 2013
- Last updated
- Dec 10, 2013
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 | 037114-1 | NY | Yes |
Practice location
100 Saint Regis DrMassapequa Park, NY 11762-3451
Phone 516-795-3789
Mailing address
5500 Merrick RdMassapequa, NY 11758-6231
Phone 516-798-3789
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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 18 Physical Therapist providers in Massapequa Park · All 410 providers in Massapequa Park
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