Provider Demographics
NPI:1235752668
Name:CITY REHAB PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:CITY REHAB PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT, DPT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREEM
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-355-9391
Mailing Address - Street 1:6937 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7265
Mailing Address - Country:US
Mailing Address - Phone:718-386-8686
Mailing Address - Fax:718-386-8685
Practice Address - Street 1:6937 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7265
Practice Address - Country:US
Practice Address - Phone:718-386-8686
Practice Address - Fax:718-386-8685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY041424OtherLICENSE