Provider Demographics
NPI:1982789673
Name:UNPRECEDENTED PT INC.
Entity type:Organization
Organization Name:UNPRECEDENTED PT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MAPT
Authorized Official - Phone:516-558-7979
Mailing Address - Street 1:10 MILBURN CT
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2013
Mailing Address - Country:US
Mailing Address - Phone:516-837-7562
Mailing Address - Fax:
Practice Address - Street 1:600 PINE HOLLOW RD
Practice Address - Street 2:APT 7-1A
Practice Address - City:EAST NORWICH
Practice Address - State:NY
Practice Address - Zip Code:11732-1042
Practice Address - Country:US
Practice Address - Phone:516-558-7979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016741-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ00V41Medicare ID - Type Unspecified