Provider Demographics
NPI:1063019388
Name:SUMMIT CARE PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:SUMMIT CARE PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOART
Authorized Official - Middle Name:DONGALLO
Authorized Official - Last Name:ASPERA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-783-2805
Mailing Address - Street 1:3759 61ST ST STE M2
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2590
Mailing Address - Country:US
Mailing Address - Phone:718-424-2273
Mailing Address - Fax:718-424-2278
Practice Address - Street 1:3759 61ST ST STE M2
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2590
Practice Address - Country:US
Practice Address - Phone:718-424-2273
Practice Address - Fax:718-424-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty