Individual provider · NPI-1

Nicholas Ahlers, PT,DPT

Physical Therapist · Bay Shore, NY

NPI number1720625940
StatusActive
Last updated in NPPESDec 9, 2020

Details

NPI
1720625940
Entity type
Individual (NPI-1)
Name
Nicholas Ahlers
Credential
PT,DPT
Sex
Male
Sole proprietor
No
Enumeration date
Dec 6, 2019
Certification date
Dec 9, 2020
Last updated
Dec 9, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist034538NYYes

Practice location

301 E Main St
Bay Shore, NY 11706-8408

Phone 631-968-3400

Mailing address

25 Overton Ave
Sayville, NY 11782-2415

Phone 631-707-6392

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