1922159359 NPI number — PERFORM PHYSICAL THERAPY AND PILATES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922159359 NPI number — PERFORM PHYSICAL THERAPY AND PILATES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERFORM PHYSICAL THERAPY AND PILATES PLLC
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:
1922159359
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
141 LIDO BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIDO BEACH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11561-4833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-220-4177
Provider Business Mailing Address Fax Number:
516-992-2282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
141 LIDO BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIDO BEACH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11561-4833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-220-4177
Provider Business Practice Location Address Fax Number:
516-992-2282
Provider Enumeration Date:
01/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STOSKI
Authorized Official First Name:
MELINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
516-220-4177

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  013055 , 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)

  • Identifier: 803355 . This is a "MPN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1495973 . This is a "CIGNA PROV #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Q35E42 . This is a "BCBS PROV #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0024301 . This is a "ORTHONET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11303 . This is a "MAGNACARE PROV #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1174577217 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0123036 . This is a "GHI PROV #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6C5374 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133998 . This is a "VYTRA PROV #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 107959P . This is a "HIP PROV #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2607498 . This is a "UHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com