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

Individual provider Physical Therapist · NPI 1578395166

Ralph Licciardi, DPT is a Physical Therapist in Private Practice in Locust Valley, New York. Qualified in 2024, 2 years ago. Practices with Soundside Physical Therapy PC, a 6-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
2
Licensed in
NY
In the registry since
2024
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

146 Birch Hill Rd
Locust Valley, NY 11560-1833
Phone: (516) 759-9717
Fax: (516) 759-1666
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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 052989 (NY)

Record details

NPI number1578395166
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedAugust 14, 2024
Last updated in NPPESAugust 14, 2024
Certification dateAugust 14, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Soundside Physical Therapy Pc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Locust Valley