Provider Demographics
NPI:1073825055
Name:SUPERIOR QUALITY PHYSICAL THERAPY AND REHAB SERVICES, P.C.
Entity Type:Organization
Organization Name:SUPERIOR QUALITY PHYSICAL THERAPY AND REHAB SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH RASHIDA
Authorized Official - Middle Name:SALUDSONG
Authorized Official - Last Name:QUINTILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-479-1640
Mailing Address - Street 1:959 BRUSH HOLLOW RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-1778
Mailing Address - Country:US
Mailing Address - Phone:646-479-1640
Mailing Address - Fax:
Practice Address - Street 1:959 BRUSH HOLLOW RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-1778
Practice Address - Country:US
Practice Address - Phone:646-479-1640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-08
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025218261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy