OrganizationNorth Shore Pt Of Ny PcPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address4870 Hylan Blvd, Staten Island, NY 10312-6322(917) 538-6692PECOS EnrollmentBased on the most recent information from CMS, provider North Shore Pt Of Ny 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 34 days ago.Profile DetailsProvider ID1922357102Provider TypeOrganizationFull NameNorth Shore Pt Of Ny PcSubpartNoEnumeration Date9/4/2012Last Updated2/20/2019Contact InformationPractice LocationPractice Address4870 Hylan Blvd, Staten Island, NY 10312-6322Phone(917) 538-6692Fax(718) 720-3895Mailing LocationMailing Address115 Overlook Ter, Staten Island, NY 10305-2715Phone(917) 538-6692Fax(718) 720-3895Authorized OfficialNameSoliman, Hammouda (Owner)Phone(917) 538-6692Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense016009-1New York