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

Form and Function Physical Therapy PC

Organization Physical Therapist · NPI 1316332505

Form and Function Physical Therapy PC is a Physical Therapist in Jericho, New York. Licensed in New York. Registered with an NPI since 2015.

Licensed in
NY
In the registry since
2015
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

55 Jericho Tpke Ste 202
Jericho, NY 11753-1013
Phone: (516) 532-0734
Fax: (516) 465-9656
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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 0179761 (NY)

Record details

NPI number1316332505
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amir Hanna — Physical Therapist · (516) 532-0734
NPI enumeratedApril 3, 2015
Last updated in NPPESApril 3, 2015
Mailing address55 Jericho Tpke, Suite 202, Jericho, NY 11753-1013

Other providers in Jericho