| Organization Name: | NORTH SHORE PHYSICAL MEDICINE AND REHABILITATION SERVICES, PC |
| NPI Number: | 1255479119 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BARRY C. ROOT (OWNER PRESIDENT) |
| Mailing Address: | 4 Expressway Plz Ste 110 Roslyn Heights |
| State: | NY US |
| Postal Code: | 115772059 |
| Phone Number: | 5166214062 |
| Fax Number: | 5166211848 |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 11/06/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225400000X |
| License Number: | 167868-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Rehabilitation Practitioner |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity. |