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Contact Information

AGEWELL PHYSICAL THERAPY AND WELLNESS, P.C.
1999 MARCUS AVE
SUITE M15
LAKE SUCCESS, NY11042-1013
 Phone: 516-488-8808
 Fax: 516-488-8818
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for AGEWELL PHYSICAL THERAPY AND WELLNESS PC · (Female)

NPI # 1861485070
Status Active
Credentials
Entity Individual
Enumeration date 08/24/2005
Last updated 03/13/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY License # 0155321
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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