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

Leo Mirochnik, PTA

Individual provider Physical Therapy Assistant · NPI 1003682808

Leo Mirochnik, PTA is a Physical Therapy Assistant in Staten Island, New York. Licensed in New York. Registered with an NPI since 2023.

Licensed in
NY
In the registry since
2023
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1351 Forest Ave
Staten Island, NY 10302-2049
Phone: (917) 722-6883
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 014055 (NY)

Record details

NPI number1003682808
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedDecember 1, 2023
Last updated in NPPESDecember 1, 2023
Certification dateNovember 27, 2023

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