Provider Demographics
NPI:1407050388
Name:DONGAN HILLS PHYSICAL THERAPY, P.L.L.C.
Entity Type:Organization
Organization Name:DONGAN HILLS PHYSICAL THERAPY, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:ARKADY
Authorized Official - Middle Name:
Authorized Official - Last Name:MIGDALOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-597-2172
Mailing Address - Street 1:90 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-1421
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2113 W 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3756
Practice Address - Country:US
Practice Address - Phone:718-714-7272
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0177571225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYS81013Medicare UPIN