Provider Demographics
NPI:1174666028
Name:QUEENS REHABILITATION CENTER
Entity Type:Organization
Organization Name:QUEENS REHABILITATION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:I
Authorized Official - Last Name:MEISEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-803-2887
Mailing Address - Street 1:9131 QUEENS BLVD
Mailing Address - Street 2:SUITE 612
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5501
Mailing Address - Country:US
Mailing Address - Phone:718-803-2887
Mailing Address - Fax:718-803-0079
Practice Address - Street 1:9131 QUEENS BLVD
Practice Address - Street 2:SUITE 612
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5501
Practice Address - Country:US
Practice Address - Phone:718-803-2887
Practice Address - Fax:718-803-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0073796OtherGHI PROVIDER # PAWLOWSKI
NY33021OtherGHI PROVIDER # MEISEL
NY17929POtherHIP PROVIDER # MEISEL
NY137096POtherHIP PROVIDER # PAWLOWSKI
NC2C0635OtherHEALTHNET PROVIDER #
NYQ71711OtherEMPIRE BLUE CROSS #
NY17929POtherHIP PROVIDER # MEISEL