Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Jefferson Sports & Physical Therapy, PC

Organization Physical Therapist · NPI 1407083686

Jefferson Sports & Physical Therapy, PC provides Physical Therapist services in Manorville, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

460 County Road 111 #15
Manorville, NY 11949
Phone: (631) 909-8712
Fax: (631) 909-8714
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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 007458 (NY)

Record details

NPI number1407083686
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brian Heim — Owner/Physical Therapist · (631) 928-2277
NPI enumeratedJune 16, 2009
Last updated in NPPESJuly 20, 2022
Certification dateJuly 20, 2022
Mailing address460 County Road 111, 15, Manorville, NY 11949

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