Organization Name: | WESTON PAXXON PT OT & SLP PLLC |
NPI Number: | 1144251620 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROGER RAYMOND BERKLEY (EXECUTIVE VP) |
Mailing Address: | 4089 Nesconset Hwy South Setauket |
State: | NY US |
Postal Code: | 117201260 |
Phone Number: | 6313311988 |
Fax Number: | 6313311988 |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 10/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251G0304X |
License Number: | 003194-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Geriatrics |
Taxonomy Definition: |