Provider Demographics
NPI:1417040684
Name:ALL CARE PHYSICAL THERAPY & REHABILITATION SERVICES PC
Entity Type:Organization
Organization Name:ALL CARE PHYSICAL THERAPY & REHABILITATION SERVICES PC
Other - Org Name:FERNANDO TAN JR PT DBA ALL CARE PHYSICAL THERAPY & REHAB. SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:TAN
Authorized Official - Last Name:TAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:516-868-8880
Mailing Address - Street 1:1158 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4205
Mailing Address - Country:US
Mailing Address - Phone:516-868-8880
Mailing Address - Fax:516-868-0685
Practice Address - Street 1:1158 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-4205
Practice Address - Country:US
Practice Address - Phone:516-868-8880
Practice Address - Fax:516-868-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011913261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ69051Medicare ID - Type UnspecifiedPHYSICAL THERAPY
NYA100027257Medicare PIN