Provider Demographics
NPI:1104507094
Name:MOTION CARE PHYSICAL THERAPY
Entity type:Organization
Organization Name:MOTION CARE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARYMIEL
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:ANETRELLA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-379-7550
Mailing Address - Street 1:175 W MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-3712
Mailing Address - Country:US
Mailing Address - Phone:516-379-7550
Mailing Address - Fax:
Practice Address - Street 1:175 W MERRICK RD
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:NY
Practice Address - Zip Code:11520-3712
Practice Address - Country:US
Practice Address - Phone:516-379-7550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOTION CARE PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-25
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty