Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Form Physical Therapy Lifestyle Wellness Pllc

Physical Therapist in Bayside, NY · enumerated 2026 · authorized official Dan Thomas, Practice Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1629903760

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name Form Physical Therapy Lifestyle Wellness Pllc

Practice address 21426 41st Ave Ste 110, Bayside, NY, 11361

Phone (718) 279-9800

Enumeration date Jun 17, 2026

Last updated in NPPES Jun 17, 2026

Taxonomy & classification

225100000X Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers Primary

Authorized official

Name Dan Thomas

Title Practice Administrator

Phone (833) 442-2053

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

What type of organization is Form Physical Therapy Lifestyle Wellness Pllc?

Form Physical Therapy Lifestyle Wellness Pllc is registered in NPPES as a Physical Therapist (its primary provider taxonomy).

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-06-17.