Provider Demographics
NPI:1235184755
Name:HECTOR PT REHABILITATION SERVICES, P.C.
Entity Type:Organization
Organization Name:HECTOR PT REHABILITATION SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:JASEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-877-4973
Mailing Address - Street 1:PO BOX 11471
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-0471
Mailing Address - Country:US
Mailing Address - Phone:518-358-9180
Mailing Address - Fax:
Practice Address - Street 1:626 WATERVLIET SHAKER RD
Practice Address - Street 2:SUITE 71
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-3618
Practice Address - Country:US
Practice Address - Phone:518-877-4970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0931Medicare PIN