Provider Demographics
NPI:1093084550
Name:3D REHABILITATION SERVICES, PT PC
Entity Type:Organization
Organization Name:3D REHABILITATION SERVICES, PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-3D REHABILITATION SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:ROMEO
Authorized Official - Middle Name:TERRY
Authorized Official - Last Name:BUGANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-656-8459
Mailing Address - Street 1:310 EAST 46 ST
Mailing Address - Street 2:SUITE 11-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017
Mailing Address - Country:US
Mailing Address - Phone:212-867-5827
Mailing Address - Fax:212-600-1894
Practice Address - Street 1:310 EAST 46 ST
Practice Address - Street 2:SUITE 11-A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:212-867-5827
Practice Address - Fax:212-600-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032461-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty