| Organization Name: | ISLAND SPORTS PHYSICAL THERAPY OF GLEN COVE PC |
| NPI Number: | 1083644116 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KEITH A MAY (PRESIDENT) |
| Mailing Address: | 4 Cedar Swamp Rd Glen Cove |
| State: | NY US |
| Postal Code: | 115423749 |
| Phone Number: | 5166716161 |
| Fax Number: | 5166740396 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 02/26/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |