Provider Demographics
NPI:1154445948
Name:HOME CARE PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:HOME CARE PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RICO
Authorized Official - Middle Name:KINTANAR
Authorized Official - Last Name:SABULAO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-844-7537
Mailing Address - Street 1:6649 MARBELLA LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105-5048
Mailing Address - Country:US
Mailing Address - Phone:914-844-7537
Mailing Address - Fax:
Practice Address - Street 1:6649 MARBELLA LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34105-5048
Practice Address - Country:US
Practice Address - Phone:914-844-7537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NY010548-1251E00000X, 261QP2000X, 320600000X, 320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No251E00000XAgenciesHome Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical DisabilitiesGroup - Single Specialty