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

Jefferson Sports & Physical Therapy, PC

Organization Physical Therapist · NPI 1407083686

Jefferson Sports & Physical Therapy, PC is a Physical Therapist in Manorville, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009
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

460 County Road 111 #15
Manorville, NY 11949
Phone: (631) 909-8712
Fax: (631) 909-8714
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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 007458 (NY)

Record details

NPI number1407083686
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brian Heim — Owner/Physical Therapist · (631) 928-2277
NPI enumeratedJune 16, 2009
Last updated in NPPESJuly 20, 2022
Certification dateJuly 20, 2022
Mailing address460 County Road 111, 15, Manorville, NY 11949

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