Provider Demographics
NPI:1275764714
Name:CMS PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:CMS PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISLAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERIF
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THRAPIST
Authorized Official - Phone:347-844-2310
Mailing Address - Street 1:2367 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-5007
Mailing Address - Country:US
Mailing Address - Phone:347-844-2310
Mailing Address - Fax:718-597-2902
Practice Address - Street 1:2367 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5007
Practice Address - Country:US
Practice Address - Phone:347-844-2310
Practice Address - Fax:718-597-2902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-31
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023514261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ3R321Medicare PIN