Organization Name: | L.I. PRO PHYSICAL THERAPY P.C. |
NPI Number: | 1104164656 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JUSTIN ANDREW MINERVA (OWNER) |
Mailing Address: | 11 Canby Ct West Islip |
State: | NY US |
Postal Code: | 117952309 |
Phone Number: | 6318736100 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2013 |
NPI Last Update Date: | 01/17/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 031214-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |