Form and Function Physical Therapy PC.
NPI 1316332505ActiveOrganization· Physical Therapist· Jericho, NY
Physical Therapist in Jericho, New York, registered in NPPES in April 2015. The authorized official on file is Amir Milad Hanna, PT, Physical Therapist.
Overview
| NPI | 1316332505 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 3, 2015 |
| Last updated in NPPES | Apr 3, 2015 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 0179761 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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All 22 physical therapists in Jericho · All physical therapists in New York