Provider Demographics
NPI:1346637790
Name:BH PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:BH PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT
Authorized Official - Prefix:
Authorized Official - First Name:PERELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-918-9509
Mailing Address - Street 1:287 NORTHERN BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4700
Mailing Address - Country:US
Mailing Address - Phone:516-918-9509
Mailing Address - Fax:
Practice Address - Street 1:287 NORTHERN BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4700
Practice Address - Country:US
Practice Address - Phone:516-918-9509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037394225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY037934OtherNY PT LICENSE
NYA100126117Medicare PIN