Provider Demographics
NPI:1013417054
Name:VITAL CARE PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:VITAL CARE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EINHORN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-522-2934
Mailing Address - Street 1:2075 E 65TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5913
Mailing Address - Country:US
Mailing Address - Phone:347-522-2934
Mailing Address - Fax:
Practice Address - Street 1:2075 E 65TH ST FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5913
Practice Address - Country:US
Practice Address - Phone:347-522-2934
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036535225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty