Provider Demographics
NPI:1508998097
Name:EXCEL CARE PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:EXCEL CARE PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:SANTOS
Authorized Official - Last Name:JABAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-683-1917
Mailing Address - Street 1:1705 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-2444
Mailing Address - Country:US
Mailing Address - Phone:631-424-5070
Mailing Address - Fax:631-424-5076
Practice Address - Street 1:1705 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-2444
Practice Address - Country:US
Practice Address - Phone:631-424-5070
Practice Address - Fax:631-424-5076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019426261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy