Individual ProviderNeil ObesoPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address97 Main St Ste H, Stony Brook, NY 11790-1900(631) 751-6680(631) 413-1757PECOS EnrollmentBased on the most recent information from CMS, provider Neil Obeso 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 ID1437754942Provider TypeIndividualFull NameObeso, NeilTitleMr.CredentialDPTGenderMaleSole ProprietorYesEnumeration Date12/2/2020Last Updated12/2/2020Contact InformationPractice LocationPractice Address97 Main St Ste H, Stony Brook, NY 11790-1900Phone(631) 751-6680FaxUnlisted FaxMailing LocationMailing Address190 Sound Beach Blvd, Sound Beach, NY 11789-1644Phone(631) 413-1757FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense046604-01New York