Provider Demographics
NPI:1396828091
Name:ABSOLUTE CARE PHYSICAL THERAPY GROUP, PLLC
Entity Type:Organization
Organization Name:ABSOLUTE CARE PHYSICAL THERAPY GROUP, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARETSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-646-8700
Mailing Address - Street 1:3065 BRIGHTON 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5501
Mailing Address - Country:US
Mailing Address - Phone:718-646-8700
Mailing Address - Fax:718-646-8726
Practice Address - Street 1:3065 BRIGHTON 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5501
Practice Address - Country:US
Practice Address - Phone:718-646-8700
Practice Address - Fax:718-646-8726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019225225100000X
NY0185701225100000X
NY0242691225100000X
NY0266141225100000X
NY0054861225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02186065Medicaid
NYQ1W2Z1Medicare ID - Type Unspecified