Provider Demographics
NPI:1326180563
Name:REHAB R US PT PC
Entity Type:Organization
Organization Name:REHAB R US PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GAMAL
Authorized Official - Middle Name:I
Authorized Official - Last Name:MOUSA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-219-1752
Mailing Address - Street 1:370 BAY RIDGE PKWY
Mailing Address - Street 2:SUITE # 6
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3153
Mailing Address - Country:US
Mailing Address - Phone:718-745-7200
Mailing Address - Fax:
Practice Address - Street 1:370 BAY RIDGE PKWY
Practice Address - Street 2:SUITE # 6
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3153
Practice Address - Country:US
Practice Address - Phone:718-745-7200
Practice Address - Fax:718-745-4811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYY24332Medicare UPIN
NYQ4W8N1Medicare PIN