Provider Demographics
NPI:1437534732
Name:NEW ERA PHYSICAL THERAPY SERVICES P.C.
Entity Type:Organization
Organization Name:NEW ERA PHYSICAL THERAPY SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:MR
Authorized Official - First Name:DIOMIDES
Authorized Official - Middle Name:
Authorized Official - Last Name:DE CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-605-3341
Mailing Address - Street 1:32 NEW HYDE PARK RD
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4935
Mailing Address - Country:US
Mailing Address - Phone:347-605-3341
Mailing Address - Fax:
Practice Address - Street 1:32 NEW HYDE PARK RD
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4935
Practice Address - Country:US
Practice Address - Phone:347-605-3341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-28
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty