Provider Demographics
NPI:1376603431
Name:PRO-TEK PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:PRO-TEK PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLURA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-489-3535
Mailing Address - Street 1:1706 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:WHITESTONE
Mailing Address - State:NY
Mailing Address - Zip Code:11357-3320
Mailing Address - Country:US
Mailing Address - Phone:718-489-3535
Mailing Address - Fax:866-217-4437
Practice Address - Street 1:1706 UTOPIA PKWY
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3320
Practice Address - Country:US
Practice Address - Phone:718-489-3535
Practice Address - Fax:866-217-4437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022343225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY681632OtherACN UNITED HEALTHCARE
NY118623946OtherFIRSTHEALTH
NY172614OtherELDERPLAN
NY353546POtherHIP
NYCB2343OtherATLANTIS
NYQL5292OtherBCBS PPO
NY3394763OtherAETNA
NYP00007467OtherMEDICARE RAILROAD
NY00000092525OtherBETTER HEALTH ADVANTAGE
NY0141466OtherGHI
NY0949623OtherCIGNA PPO
NYQL5292OtherBCBS PPO
NY0141466OtherGHI
NY0949623OtherCIGNA PPO
NY353546POtherHIP
NY3394763OtherAETNA