PRO PERFORMANCE PHYSICAL THERAPY AND WELLNESS, PLLC (NPI# 1821262809) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821262809 |
| Entity Type | Organization |
| Organization Name | PRO PERFORMANCE PHYSICAL THERAPY AND WELLNESS, PLLC |
| Practice Address |
70 Glen St Suite 380 Glen Cove NY 11542-2855 |
| Practice Telephone | 5162771153 |
| Practice Fax Number | 5162771154 |
| Mailing Telephone | 5162771153 |
| Mailing Fax Number | 5162771154 |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2008-10-01 |
| Authorized Official Name | MR. JONATHAN A VENEGAS (MEMBER) |
| Authorized Official Telephone | 5162771153 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251N0400X |
Physical Therapist Specialization: Neurology |
015585-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
015585-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
015585-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | PRO PERFORMANCE PHYSICAL THERAPY AND WELLNESS, PLLC | 70 Glen Street / Suite 380, Glen Cove, Ny 11542 |
| Street Address |
70 GLEN ST SUITE 380 |
| City | GLEN COVE |
| State | NY |
| Zip Code | 11542-2855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366436305 | Edward Skwiersky | Internal Medicine | 70 Glen St, Suite 200, Glen Cove, NY 11542-2854 | 2005-09-06 |
| 1700175270 | North Shore Lij Medical Group At North Nassau, PC | Internal Medicine | 70 Glen St, Suite 200, Glen Cove, NY 11542-2855 | 2011-04-05 |
| 1407040520 | Kathryn Calabria, Do,pc | Preventive Medicine | 70 Glen St, Suite 300, Glen Cove, NY 11542-2855 | 2007-08-31 |
| 1275726911 | Eastern Audiology Resources, Ltd., PC | Audiologist-Hearing Aid Fitter | 70 Glen St, Suite 100, Glen Cove, NY 11542-2855 | 2007-08-27 |
| 1457565038 | Footcare Services of Lic | Podiatrist | 70 Glen St, Suite 380, Glen Cove, NY 11542-2855 | 2007-05-10 |
| 1952435000 | Richard Rise Physician PC | Psychiatry & Neurology | 70 Glen St, Suite 101, Glen Cove, NY 11542-2855 | 2007-03-14 |
| 1407925365 | Sea Cliff Chiropractic Office PC | Chiropractor | 70 Glen St, Suite 380, Glen Cove, NY 11542-2858 | 2006-11-07 |
| 1477637312 | Jesse Andrew Stoff | Allergy & Immunology | 70 Glen St, Suite 300, Glen Cove, NY 11542-2855 | 2006-10-25 |
| 1538249131 | Susan Bressi Hamilton | Audiologist-Hearing Aid Fitter | 70 Glen St, Suite 100, Glen Cove, NY 11542-2790 | 2006-10-17 |
| 1306946991 | John Joseph Weber Jr. | Podiatrist | 70 Glen St, Suite 380, Glen Cove, NY 11542-2855 | 2006-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104468461 | Yvonne N Valcourt | Registered Nurse | 14 Burns Ave, Glen Cove, NY 11542 | 2019-10-08 |
| 1508419771 | Gregory Stephen Bonistalli | Audiologist | 70 Glen St Ste 100, Glen Cove, NY 11542 | 2019-07-17 |
| 1861954646 | Pulkit Malik | Student in an Organized Health Care Education/Training Program | Northwell Health Glen Cove Hospital, 101 St. Andrews Lane, Glen Cove, NY 11542 | 2019-04-02 |
| 1912498783 | Rays of Light Companion Care Agency LLC | Long Term Care Hospital | 70 Forest Ave # 2g, Glen Cove, NY 11542 | 2018-05-28 |
| 1164978391 | Nithin Kuruvilla | Pharmacist | 421 Glen Cove Road, East Hills, NY 11542 | 2016-08-28 |
| 1063879245 | Kerri A Sujeski | Physician Assistant | 104 Forest Avenue, Glen Cove, NY 11542 | 2016-01-19 |
| 1093110884 | Sherri Meagher | Social Worker | 130 Glen Street, Glen Cove, NY 11542 | 2014-10-23 |
| 1174946537 | Lori Seele | Psychologist | Ridge Drive, Connolly Elementary School, Glen Cove, NY 11542 | 2014-01-21 |
| 1255671210 | Wendy S Grossman | Speech-Language Pathologist | 2 Dosoris Lane, Deasy School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-27 |
| 1033459318 | Kristin Strelec | Social Worker | Seaman & Walnut Roads, Gribbin School Glen Cove School District, Glen Cove, NY 11542 | 2013-02-22 |
| Find all providers in zip 11542 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881104339 | Karen Michelle Danchalski | Physical Therapist | 3 School St Ste 205, Glen Cove, NY 11542-2548 | 2017-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760152 | Molly Ripp | Physical Therapist | 1165 Northern Blvd Ste 403, Manhasset, NY 11030-3048 | 2020-11-02 |
| 1982202024 | Integrated Pt2 Pllc | Physical Therapist | 4720 Center Blvd Apt 3006, Long Island City, NY 11109-5648 | 2020-10-12 |
| 1891392940 | Dr Omolola Omishore Pt, P.C. | Physical Therapist | 1138 Ocean Ave Apt 6i, Brooklyn, NY 11230 | 2020-10-01 |
| 1912514704 | Hochung Jeon | Physical Therapist | 4545 Center Blvd Apt 904, Long Island City, NY 11109-5917 | 2020-09-25 |
| 1831704469 | Colleen M Brough | Physical Therapist | 710 W 168th St Ste 336, New York, NY 10032-3726 | 2020-09-10 |
| 1225641731 | Kyle Dillon | Physical Therapist | 667 Stoneleigh Ave Ste 11, Carmel, NY 10512-2454 | 2020-08-25 |
| 1346853033 | R.l. Physical Therapy | Physical Therapist | 1676 Putney Road, Valley Stream, NY 11580 | 2020-08-24 |
| 1194335059 | Donn Samson | Physical Therapist | 8762 52nd Ave Fl 2, Elmhurst, NY 11373-3938 | 2020-08-05 |
| 1679195499 | Vital Rehab LLC | Physical Therapist | 3165 Nostrand Ave Apt 4e, Brooklyn, NY 11229-3243 | 2020-05-14 |
| 1508485657 | Melvin Varghese | Physical Therapist | 172 Hoover Rd, Yonkers, NY 10710-3409 | 2020-04-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.