Provider profile · NPI 1710404173

101 Avenue Physical Therapy Pc

Physical Therapist · Great Neck, NY · NPI 1710404173 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Physical Therapist

Enumerated

Aug 26, 2017

License(s)

36145 (NY)

Addresses on file

PurposeAddressCity/StatePhone
MAILING277 NORTHERN BLVD STE 301 Great Neck, NY 11021-4703
LOCATION277 NORTHERN BLVD STE 301 Great Neck, NY 11021-4703516-472-7861

View on NPPES registry ↗

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