MRS. KELLY J. SACK (NPI# 1760538631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760538631 |
| Entity Type | Individual |
| Full Name | MRS. KELLY J. SACK |
| Credential | M.P.T. |
| Practice Address |
45 Crossway E Bohemia NY 11716-1204 |
| Mailing Address |
116 Bucknell Rd West Sayville NY 11796-1005 |
| Practice Telephone | 6312184949 |
| Mailing Telephone | 6312586111 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
019478 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
45 CROSSWAY E |
| City | BOHEMIA |
| State | NY |
| Zip Code | 11716-1204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073669941 | Nicole Schiffmacher | Physical Therapist | 45 Crossway E, Bohemia, NY 11716-1204 | 2007-01-25 |
| 1033762653 | Jennifer Kobelski | Occupational Therapist | 45 Crossway E, Bohemia, NY 11716-1204 | 2019-07-23 |
| 1386121150 | Courtney Brooke Alberts | Occupational Therapist | 45 Crossway E, Bohemia, NY 11716-1204 | 2018-07-25 |
| 1649766338 | Christina Frances Randazzo | Speech-Language Pathologist | 45 Crossway E, Bohemia, NY 11716-1204 | 2018-07-05 |
| 1023536562 | Celia Schweighardt | Registered Nurse | 45 Crossway E, Bohemia, NY 11716-1204 | 2017-09-05 |
| 1740708734 | Jacquelin Bahret | Physical Therapist | 45 Crossway E, Bohemia, NY 11716-1204 | 2017-08-30 |
| 1407302391 | Liana Maria Gilbert | Occupational Therapist | 45 Crossway E, Bohemia, NY 11716-1204 | 2016-08-30 |
| 1235586090 | Jennifer Hackett | Specialist | 45 Crossway E, Bohemia, NY 11716-1204 | 2016-05-20 |
| 1689036501 | Michelle Schub | Occupational Therapist | 45 Crossway E, Bohemia, NY 11716-1204 | 2016-03-22 |
| 1477920114 | Samantha Preya Baiju | Registered Nurse | 45 Crossway E, Bohemia, NY 11716-1204 | 2015-08-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548774631 | Laura M Goldschrafe | Midwife | 4875 Sunrise Hwy Ste 200, Bohemia, NY 11716 | 2017-11-28 |
| 1881141364 | Mas Imaging | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 2 Kane Court, Huntington, NY 11716 | 2016-09-01 |
| 1255717252 | Lynne G Slovin | Social Worker | 700 Lakeland Avenue, Ste. 1c, Bohemia, NY 11716 | 2015-08-03 |
| 1194164855 | Michelle Lynn Salz | Midwife | 4875 Sunrise Highway, Bohemia, NY 11716 | 2013-06-17 |
| 1700222411 | Caring Hands | Home Health | 21 Carolyn Ct, Bohemia, NY 11716 | 2013-05-21 |
| 1619210069 | Michael Roche | Counselor | 1650 Syamore Ave, Suite 39, Bohemia, NY 11716 | 2013-04-04 |
| 1063727949 | Diane Alana Dicarlo | Acupuncturist | 638 Ocean Avenue, Bohemia, NY 11716 | 2010-08-16 |
| 1467786632 | Elaina Andersen | Occupational Therapist | 907 Sycamore Avenue, Bohemia, NY 11716 | 2009-09-22 |
| 1356518484 | Kenneth John Grau | Speech-Language Pathologist | 45 Crossways East Rd, Saul &elainne Seiff Educare Center, Bohemia, NY 11716 | 2008-05-08 |
| 1790907574 | Thomas J Riviello | Counselor | 600 Johnson Avenue, Bohemia, NY 11716 | 2007-05-02 |
| Find all providers in zip 11716 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225451768 | Christine Mongiardo | Physical Therapist | 45 Crossway E, Bohemia, NY 11716-1204 | 2014-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021335 | Margaret E O'neil | Physical Therapist | 180 Fort Washington St, Harkness 1-164, New York, NY 10032 | 2020-07-23 |
| 1295398279 | Developmental Steps, LLC | Physical Therapist | 388 Westchester Ave Ste 1a-1b, Port Chester, NY 10573-3650 | 2019-04-16 |
| 1982176079 | Abilities Center, Pllc | Physical Therapist | 10 Mountain Ledge, Wilton, NY 12831-2539 | 2018-12-30 |
| 1922575026 | Hallie Rebecca Stock | Physical Therapist | 74 Stuyvesant Ave, Larchmont, NY 10538-2730 | 2018-10-26 |
| 1508331281 | Jaya Rachwani Parshotam | Physical Therapist | 323 W 96th St Apt 509, New York, NY 10025-6279 | 2018-10-09 |
| 1730663931 | Monica Isabel Bhardwaj | Physical Therapist | 1044 Cove Rd, Mamaroneck, NY 10543-4308 | 2018-09-24 |
| 1952884934 | Jumping Feet Mgmt Corp. | Physical Therapist | 175 19th St Apt 501, Brooklyn, NY 11232-1026 | 2018-09-14 |
| 1467934000 | Victoria Buchanan | Physical Therapist | 199 Thorncliff Rd, Buffalo, NY 14223-1241 | 2018-08-30 |
| 1841786324 | Sunshine Rehab Pt PC | Physical Therapist | 19840 32nd Ave Apt B2, Flushing, NY 11358 | 2018-07-08 |
| 1346734472 | Dale Scalise-smith | Physical Therapist | 24 Osborn St, Stony Point, NY 10980-3651 | 2018-06-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.