Provider Demographics
NPI:1003293366
Name:PHYSICAL MEDICINE & REHABILITATION OF LONG ISLAND,PLLC
Entity Type:Organization
Organization Name:PHYSICAL MEDICINE & REHABILITATION OF LONG ISLAND,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:RAI
Authorized Official - Suffix:
Authorized Official - Credentials:DO, MPH
Authorized Official - Phone:631-300-0797
Mailing Address - Street 1:234 ORINOCO DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWATERS
Mailing Address - State:NY
Mailing Address - Zip Code:11718-1822
Mailing Address - Country:US
Mailing Address - Phone:631-300-0797
Mailing Address - Fax:631-647-8429
Practice Address - Street 1:234 ORINOCO DR
Practice Address - Street 2:
Practice Address - City:BRIGHTWATERS
Practice Address - State:NY
Practice Address - Zip Code:11718-1822
Practice Address - Country:US
Practice Address - Phone:631-300-0797
Practice Address - Fax:631-647-8429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty