Provider Demographics
NPI:1083874614
Name:NOT JUST PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:NOT JUST PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:DARDIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:7184-949-4969
Mailing Address - Street 1:34 RAMSEY LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-5195
Mailing Address - Country:US
Mailing Address - Phone:718-494-4969
Mailing Address - Fax:
Practice Address - Street 1:2327 83RD ST
Practice Address - Street 2:SUITE A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2750
Practice Address - Country:US
Practice Address - Phone:718-513-4577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022859174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty