Provider Demographics
NPI:1508374026
Name:FOCUS ACUPUNCTURE AND PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:FOCUS ACUPUNCTURE AND PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:PT, LAC
Authorized Official - Phone:516-851-9056
Mailing Address - Street 1:4 BRETON AVE
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1302
Mailing Address - Country:US
Mailing Address - Phone:516-851-9056
Mailing Address - Fax:
Practice Address - Street 1:104 BENKERT ST
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-3002
Practice Address - Country:US
Practice Address - Phone:516-490-9085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
NY021102225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty