Provider Demographics
NPI:1467523076
Name:HAND REHABILITATION AND PHYSICAL THERAPY GROUP, LLP
Entity Type:Organization
Organization Name:HAND REHABILITATION AND PHYSICAL THERAPY GROUP, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRUBAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:014-761-8705
Mailing Address - Street 1:280 N CENTRAL AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1832
Mailing Address - Country:US
Mailing Address - Phone:914-761-8705
Mailing Address - Fax:914-761-4041
Practice Address - Street 1:280 N CENTRAL AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1832
Practice Address - Country:US
Practice Address - Phone:914-761-8705
Practice Address - Fax:914-761-4041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019319225100000X
NY342225XH1200X
NY5762225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ1WPQ1Medicare PIN