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

Charlotte Ellen Grace Bodack

Individual provider Physical Therapist · NPI 1255284477

Charlotte Ellen Grace Bodack is a Physical Therapist in Private Practice in Bethpage, New York. Qualified in 2025, 1 year ago. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2026

Practice location Address checks out

4250 Hempstead Tpke
Bethpage, NY 11714-5711
Phone: (516) 579-7870
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 054732 (NY)

Record details

NPI number1255284477
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 17, 2026
Last updated in NPPESFebruary 17, 2026
Certification dateFebruary 17, 2026
Mailing address1650 Lyndon Farm Ct Ste 300, Louisville, KY 40223-5005

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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