| Organization Name: | LONG ISLAND SPORTS & REHABILITATION CENTER |
| NPI Number: | 1063612943 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LOIS CLOUD-MALENCZAK (DIRECTOR) |
| Mailing Address: | 4800 Veterans Hwy Holbrook |
| State: | NY US |
| Postal Code: | 117414512 |
| Phone Number: | 6315638400 |
| Fax Number: | 6315895582 |
| NPI Enumeration Date: | 07/19/2007 |
| NPI Last Update Date: | 05/21/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 00587-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |