Provider Demographics
NPI:1073339743
Name:PLATT, SALLY (PT, DPT)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:
Last Name:PLATT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 BRUSH HOLLOW RD FL 4
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1740
Mailing Address - Country:US
Mailing Address - Phone:516-474-2816
Mailing Address - Fax:
Practice Address - Street 1:559 GRAMATAN AVE STE 203
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:NY
Practice Address - Zip Code:10552-2156
Practice Address - Country:US
Practice Address - Phone:914-313-8034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist