1215159355 NPI number — BERNARD FINNERTY D/B/A HAMPTON PHYSICAL THERAPY

Table of content: SHANNON ROCHELLE RIVARD RPH (NPI 1063428183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215159355 NPI number — BERNARD FINNERTY D/B/A HAMPTON PHYSICAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BERNARD FINNERTY D/B/A HAMPTON PHYSICAL THERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215159355
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
188 W MONTAUK HWY
Provider Second Line Business Mailing Address:
SUITEE4
Provider Business Mailing Address City Name:
HAMPTON BAYS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11946-2363
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-728-6377
Provider Business Mailing Address Fax Number:
631-728-6922

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
188 W MONTAUK HWY
Provider Second Line Business Practice Location Address:
SUITEE4
Provider Business Practice Location Address City Name:
HAMPTON BAYS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11946-2363
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-728-6377
Provider Business Practice Location Address Fax Number:
631-728-6922
Provider Enumeration Date:
05/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FINNERTY
Authorized Official First Name:
BERNARD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PHYSICAL THERAPIST
Authorized Official Telephone Number:
631-728-6377

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  003881 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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