Provider Demographics
NPI:1063843571
Name:FIRST AID PT PC
Entity Type:Organization
Organization Name:FIRST AID PT PC
Other - Org Name:PRIME PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BONS
Authorized Official - Middle Name:
Authorized Official - Last Name:VORIK
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:917-476-2884
Mailing Address - Street 1:26270 HYLAN BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306
Mailing Address - Country:US
Mailing Address - Phone:718-351-2300
Mailing Address - Fax:718-351-2301
Practice Address - Street 1:26270 HYLAN BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306
Practice Address - Country:US
Practice Address - Phone:718-351-2300
Practice Address - Fax:718-351-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-09
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400048390Medicare PIN