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

South Shore Wellness Physical Therapy PC

Organization Physical Therapist · NPI 1013505734

South Shore Wellness Physical Therapy PC provides Physical Therapist services in Port Jefferson Station, New York. Registered with an NPI since 2021.

In the registry since
2021
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

1041 Route 112
Port Jefferson Station, NY 11776-6000
Phone: (631) 828-4545
Fax: (631) 828-4552
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1013505734
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Glenda Mapa — Owner · (631) 828-4545
NPI enumeratedJanuary 7, 2021
Last updated in NPPESJanuary 7, 2021
Certification dateJanuary 7, 2021
Mailing address1041 Route 112, Port Jefferson Station, NY 11776-6000

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