Dimitry Pettaway
Dimitry Pettaway is a Physical Therapist in Oceanside, New York. Practices as a sole proprietor. Registered with an NPI since 2025.
- In the registry since
- 2025
Practice location Address checks out
2837 Long Beach RdOceanside, NY 11572-2233
Phone: (516) 461-6919
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Specialties & licences
| Physical Therapist (primary) | Taxonomy 225100000X |
|---|
Record details
| NPI number | 1154203164 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 22, 2025 |
| Last updated in NPPES | July 22, 2025 |
| Certification date | July 22, 2025 |
| Mailing address | 576 Broadhollow Rd, Melville, NY 11747-5012 |
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