Provider Demographics
NPI:1497151310
Name:RESILIENT CARE PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:RESILIENT CARE PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORCILLA-ALARCON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-426-7900
Mailing Address - Street 1:5718 WOODSIDE AVE STE BASEMENT
Mailing Address - Street 2:B102
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3415
Mailing Address - Country:US
Mailing Address - Phone:718-426-7900
Mailing Address - Fax:
Practice Address - Street 1:5718 WOODSIDE AVE STE BASEMENT
Practice Address - Street 2:B102
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3415
Practice Address - Country:US
Practice Address - Phone:718-426-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-05
Last Update Date:2014-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030029225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty