Provider Demographics
NPI:1477503779
Name:HEALING TOUCH PHYSICAL THERAPY & REHABILITATION P C
Entity Type:Organization
Organization Name:HEALING TOUCH PHYSICAL THERAPY & REHABILITATION P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEDHEESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:PERUVINGAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:516-616-0942
Mailing Address - Street 1:1605 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2603
Mailing Address - Country:US
Mailing Address - Phone:516-616-0942
Mailing Address - Fax:516-616-0943
Practice Address - Street 1:1605 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2603
Practice Address - Country:US
Practice Address - Phone:516-616-0942
Practice Address - Fax:516-616-0943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018928225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY204447POtherHIP
NY11239528OtherCAQH
NY64501OtherCIGNA
NY6604549OtherGHI
NY7195795OtherAETNA
NY02198447Medicaid
NY225645OtherUNITED HEALTH CARE
NY02198447Medicaid
NY204447POtherHIP