Form And Function Physical Therapy Pc. - Physical Therapist in Jericho, NY

Form And Function Physical Therapy Pc. is a Physical Therapist based in Jericho, New York. Form And Function Physical Therapy Pc. is licensed to practice in New York (license number 0179761) and their current practice location is 55 Jericho Tpke, Suite 202, Jericho, New York. It can be reached at their office (for appointments etc.) via phone at (516) 532-0734.

NPI number for Form And Function Physical Therapy Pc. is 1316332505 and their current mailing address is 55 Jericho Tpke, Suite 202, Jericho, New York. Form And Function Physical Therapy Pc. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1316332505.

Contact Information

Form And Function Physical Therapy Pc.
55 Jericho Tpke, Suite 202,
Jericho, NY 11753-1013
(516) 532-0734
(516) 465-9656



Healthcare Provider's Profile

Full NameForm And Function Physical Therapy Pc.
TypeFacility
SpecialityPhysical Therapist
Location55 Jericho Tpke, Jericho, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1316332505
  • Provider Enumeration Date: 04/03/2015
  • Last Update Date: 04/03/2015

Medical Identifiers

Medical identifiers for Form And Function Physical Therapy Pc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316332505NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist 0179761 (New York)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Form And Function Physical Therapy Pc. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Form And Function Physical Therapy Pc.
55 Jericho Tpke, Suite 202,
Jericho, NY 11753-1013

Ph: (516) 532-0734
Form And Function Physical Therapy Pc.
55 Jericho Tpke, Suite 202,
Jericho, NY 11753-1013

Ph: (516) 532-0734

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Physical Therapist in Jericho, NY

Jaime Philip, P.T.
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 400 N Broadway, Suite D, Jericho, NY 11753
Phone: 516-827-9446    Fax: 516-827-0042
Wilda Lacdao Peralta, PT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 33 S Service Rd Rm 109, Jericho, NY 11753
Phone: 516-750-9760    Fax: 516-495-7242
Pooja Pratik Mehta,
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 33 South Service Road, Room 109, Jericho, NY 11753
Phone: 516-750-9760    
Jericho Wellness Llc
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 55 Jericho Tpke Ste 102, Jericho, NY 11753
Phone: 516-506-7888    Fax: 516-833-6044
Kidsperfect Pt Pc
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 67 Forsythia Ln, Jericho, NY 11753
Phone: 917-415-0746    
Anuya Vinayak Dukle, DPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 33 S Service Rd, Room 109, Jericho, NY 11753
Phone: 516-750-9760    

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