OrganizationActive
Champion Professional Services
NPI 1487998183 · Geriatric Physical Therapist · Miller Place, NY
Provider details
- NPI number
- 1487998183
- Entity type
- Organization
- Primary specialty
- Geriatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Michael Lyons, President(631) 828-4373
- License
- 18775 (NY)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
93 Tallmadge Trl
Miller Place, NY 11764-2327
Phone: (631) 828-4373
Fax: (631) 828-4373
Approximate (ZIP-level) locationGet directions
Mailing address
93 Tallmadge Trl
Miller Place, NY 11764-2327
Registry dates
- Enumerated
- 2012-11-19
- Last updated
- 2012-11-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.