Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Form and Function Physical Therapy PC

Organization Physical Therapist · NPI 1316332505

Form and Function Physical Therapy PC provides Physical Therapist services 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 Not confirmed with CMS for 11 years — call before visiting
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