Provider Demographics
NPI:1104159797
Name:FIVE TOWNS PHYSICAL THERAPY
Entity type:Organization
Organization Name:FIVE TOWNS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:INGBER
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:516-569-6800
Mailing Address - Street 1:20 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1305
Mailing Address - Country:US
Mailing Address - Phone:516-569-6800
Mailing Address - Fax:516-569-8739
Practice Address - Street 1:20 CENTRE ST
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1305
Practice Address - Country:US
Practice Address - Phone:516-569-6800
Practice Address - Fax:516-569-8739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-14
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0087521225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02232653Medicaid
NYQ54881Medicare PIN