Provider Demographics
NPI:1508889973
Name:REHABILITATION PHYSICAL THERAPY SERVICES, P.C.
Entity Type:Organization
Organization Name:REHABILITATION PHYSICAL THERAPY SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAZA - LESMES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-863-3292
Mailing Address - Street 1:1578 WILLIAMSBRIDGE RD. SUITE 3D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-6268
Mailing Address - Country:US
Mailing Address - Phone:718-863-3292
Mailing Address - Fax:718-863-3290
Practice Address - Street 1:1578 WILLIAMSBRIDGE RD. SUITE 3D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-6268
Practice Address - Country:US
Practice Address - Phone:718-863-3292
Practice Address - Fax:718-863-3290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy