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

Michael Scottodimaso and Tara Derosa, PT, OT, PLLC

Organization Physical Therapist · NPI 1154575074

Michael Scottodimaso and Tara Derosa, PT, OT, PLLC is a Physical Therapist in Babylon, New York. Works from 3 locations. Licensed in New York.

Licensed in
NY
In the registry since
2008
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

51 John St Ste 3
Babylon, NY 11702-2928
Phone: (631) 669-0333
Fax: (631) 669-2436
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 5500 Merrick Rd, Massapequa, NY 11758-6231 — (631) 669-0333
  • 111 Grand Ave, Massapequa, NY 11758-4905 — (631) 669-0333

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 0129451 (NY)
Occupational Therapist Taxonomy 225X00000X

Record details

NPI number1154575074
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Scottodimaso — Owner · (631) 669-0333
Other names Cbc Ctr For Sports & Physical Therapy
NPI enumeratedNovember 5, 2008
Last updated in NPPESMarch 20, 2026
Certification dateMarch 20, 2026
Mailing address51 John St Ste 3, Babylon, NY 11702-2928

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