Provider Demographics
NPI:1437576857
Name:SUNRISE PHYSICAL THERAPY AND REHABILITATION SERVICES
Entity Type:Organization
Organization Name:SUNRISE PHYSICAL THERAPY AND REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REUVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-393-3844
Mailing Address - Street 1:18911 COLLINS AVE.
Mailing Address - Street 2:APT. 405
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-2388
Mailing Address - Country:US
Mailing Address - Phone:718-393-3844
Mailing Address - Fax:718-393-3479
Practice Address - Street 1:6254 97TH PL
Practice Address - Street 2:STE 1A
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1346
Practice Address - Country:US
Practice Address - Phone:718-393-3844
Practice Address - Fax:718-393-3479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015861225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty