Provider Demographics
NPI:1447479563
Name:SOUTH SHORE PEDIATRIC PHYSICAL THERAPY,LLP
Entity type:Organization
Organization Name:SOUTH SHORE PEDIATRIC PHYSICAL THERAPY,LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FINNERAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT,DPT,PCS
Authorized Official - Phone:516-785-5257
Mailing Address - Street 1:2415 JERUSALEM AVE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1870
Mailing Address - Country:US
Mailing Address - Phone:516-785-5257
Mailing Address - Fax:516-785-5154
Practice Address - Street 1:2415 JERUSALEM AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:NORTH BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-1870
Practice Address - Country:US
Practice Address - Phone:516-785-5257
Practice Address - Fax:516-785-5154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty