Provider Demographics
NPI:1083329684
Name:GATE REHABILITATION PT PC
Entity Type:Organization
Organization Name:GATE REHABILITATION PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:718-338-5382
Mailing Address - Street 1:3857 KINGS HWY APT 1L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-2949
Mailing Address - Country:US
Mailing Address - Phone:718-338-5382
Mailing Address - Fax:718-338-2032
Practice Address - Street 1:3857 KINGS HWY APT 1L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-2949
Practice Address - Country:US
Practice Address - Phone:718-338-5382
Practice Address - Fax:718-338-2032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty