OLYMPUS PT PC
NPI 1215428370
Physical Medicine & Rehabilitation - Sports Medicine in Northport, NY

Active since May 24, 2018
694 FORT SALONGA RD, NORTHPORT, NY 11768(631) 754-3775(631) 754-3816 Get Directions Write a Review

NPPES record last updated: October 13, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Oct 13, 2020, May 24, 2018 (2 updates tracked since 2018).

  • Organization
  • Physical Medicine & Rehabilitation
  • Sports Medicine

About OLYMPUS PT PC

This page provides the complete NPI Profile along with additional information for Olympus Pt Pc, a provider established in Northport, New York operating as a Physical Medicine & Rehabilitation, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1215428370 assigned on May 2018. The practitioner's primary taxonomy code is 2081S0010X with license number 032114 (NY). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Quennie Ladao-soto Pt (Owner)

NPI
1215428370 Verify this NPI
Provider Name
OLYMPUS PT PC
Entity Type
Organization
Location Address
694 FORT SALONGA RD NORTHPORT, NY 11768
Location Phone
(631) 754-3775
Location Fax
(631) 754-3816
Mailing Address
2403 64TH ST APT 1F BROOKLYN, NY 11204
Mailing Phone
(914) 444-6235
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-24-2018
Last Update Date
10-13-2020
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Medicine & Rehabilitation Sports Medicine

Taxonomy Code
2081S0010X
Type
Allopathic & Osteopathic Physicians
License No.
032114
License State
NY
Taxonomy Description
A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

QUENNIE LADAO-SOTO PT

Authorized Official Title
OWNER
Authorized Official Phone
(914) 444-6235

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Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Dietitian, Registered
694 FORT SALONGA RD
NORTHPORT, NY 11768
Specialist
694 FORT SALONGA RD, SUITE 2
NORTHPORT, NY 11768
Physical Therapist
694 FORT SALONGA RD
NORTHPORT, NY 11768
Chiropractor
694 FORT SALONGA RD
NORTHPORT, NY 11768

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215428370, enumerated as an "organization" on May 24, 2018.

The provider is located at 694 FORT SALONGA RD NORTHPORT, NY 11768 and the phone number is (631) 754-3775.

Physical Medicine & Rehabilitation with taxonomy code 2081S0010X and a focus in Sports Medicine.