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ST TEREIZA OFF OF PHY TER PC NPI 1568657575


NPI Information

NPI: 1568657575
Provider Name: ST TEREIZA OFF OF PHY TER PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1787 MIDDLE COUNTRY RD
CENTEREACH, NY
ZIP 11720
Phone: (631) 467-3381
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ST TEREIZA OFF OF PHY TER PC is a specialist in Centereach, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ST TEREIZA OFF OF PHY TER PC NPI is 1568657575. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1787 MIDDLE COUNTRY RD
CENTEREACH, NY
ZIP 11720-507
Phone: (631) 467-3381
Fax: (631) 467-3383

The provider's authorized official is Malak Ishak Azab .
The authorized official title is Doctor Of Physical Therapy and has the following contact phone number (631) 467-3381.

The enumeration date for this NPI number is 9/12/2007 and was last updated on 6/19/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist021295NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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