OrganizationProfessional Orthopedic And Sports Physical Therapy, PcPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1 Chapman Pkwy, Stony Brook, NY 11790-1756(718) 819-6805PECOS EnrollmentBased on the most recent information from CMS, provider Professional Orthopedic And Sports Physical Therapy, Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1093160590Provider TypeOrganizationFull NameProfessional Orthopedic And Sports Physical Therapy, PcSubpartNoEnumeration Date5/3/2016Last Updated5/3/2016Contact InformationPractice LocationPractice Address1 Chapman Pkwy, Stony Brook, NY 11790-1756Phone(718) 819-6805Fax(347) 841-9109Mailing LocationMailing Address2142 Utopia Pkwy, Whitestone, NY 11357-4142Phone(718) 819-6805Fax(347) 841-9109Authorized OfficialNameBrush, Kathleen (Credentialing Manager)Phone(718) 819-6805Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer