Provider Demographics
NPI:1063819738
Name:ACHIEVERS FIRST STEP REHAB PT PC
Entity Type:Organization
Organization Name:ACHIEVERS FIRST STEP REHAB PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEDHAT
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELNAZER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DPT, PT
Authorized Official - Phone:929-245-0631
Mailing Address - Street 1:2769 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5061
Mailing Address - Country:US
Mailing Address - Phone:929-245-0631
Mailing Address - Fax:718-676-7756
Practice Address - Street 1:2769 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5061
Practice Address - Country:US
Practice Address - Phone:929-245-0631
Practice Address - Fax:718-676-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033753320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities