Provider Demographics
NPI:1356864177
Name:REHAB 360 PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PLLC
Entity Type:Organization
Organization Name:REHAB 360 PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST / PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDONIZIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-797-9797
Mailing Address - Street 1:71 CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-2767
Mailing Address - Country:US
Mailing Address - Phone:718-797-9797
Mailing Address - Fax:718-797-9796
Practice Address - Street 1:71 CARROLL ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-2767
Practice Address - Country:US
Practice Address - Phone:718-797-9797
Practice Address - Fax:718-797-9796
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROKINETICS PHYSICAL THERAPY P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
019621-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty