Provider Demographics
NPI:1184669046
Name:QUEENS PHYSICAL THERAPY ASSOCIATES LLP
Entity Type:Organization
Organization Name:QUEENS PHYSICAL THERAPY ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DHSC, OCS
Authorized Official - Phone:718-544-5730
Mailing Address - Street 1:6940 108TH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3851
Mailing Address - Country:US
Mailing Address - Phone:718-544-5730
Mailing Address - Fax:718-544-0414
Practice Address - Street 1:6940 108TH ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3851
Practice Address - Country:US
Practice Address - Phone:718-544-5730
Practice Address - Fax:718-544-0414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003980174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03728IMedicare ID - Type Unspecified
NY03728TMedicare ID - Type Unspecified
NY03728JMedicare ID - Type Unspecified
NY03728HMedicare ID - Type Unspecified
NY03728GMedicare ID - Type UnspecifiedPROVIDER NUMBER