Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Age Actively Physical Therapy, PC

Organization Physical Therapist · NPI 1790116549

Age Actively Physical Therapy, PC is a Physical Therapist in North Baldwin, New York. Licensed in New York. Registered with an NPI since 2013.

Licensed in
NY
In the registry since
2013
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1633 Westervelt Ave
North Baldwin, NY 11510-1650
Phone: (516) 343-6195
Fax: (516) 208-5005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 017711-1 (NY)

Record details

NPI number1790116549
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Edgar Biazon — President · (516) 343-6195
NPI enumeratedDecember 4, 2013
Last updated in NPPESDecember 4, 2013
Mailing address1633 Westervelt Ave, North Baldwin, NY 11510-1650

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