Provider Demographics
NPI:1053467837
Name:PHYSICAL THERAPY UNLIMITED, PLLC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY UNLIMITED, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL RAY
Authorized Official - Middle Name:DE GRACIA
Authorized Official - Last Name:SINDO
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:718-336-4390
Mailing Address - Street 1:2919 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4063
Mailing Address - Country:US
Mailing Address - Phone:718-336-4390
Mailing Address - Fax:718-336-4395
Practice Address - Street 1:2919 AVENUE T
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4063
Practice Address - Country:US
Practice Address - Phone:718-336-4390
Practice Address - Fax:718-336-4395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ4WCD1Medicare ID - Type Unspecified