Provider Demographics
NPI:1245754225
Name:REHAB ON WHEELS OT PT PLLC
Entity Type:Organization
Organization Name:REHAB ON WHEELS OT PT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:MR
Authorized Official - First Name:DMITRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEVCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-395-7445
Mailing Address - Street 1:174 BAY 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5020
Mailing Address - Country:US
Mailing Address - Phone:718-395-7445
Mailing Address - Fax:
Practice Address - Street 1:174 BAY 29TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5020
Practice Address - Country:US
Practice Address - Phone:718-395-7445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty