Provider Demographics
NPI:1518336791
Name:PROGRESSIVE REHAB & STRENGTH,LLC
Entity Type:Organization
Organization Name:PROGRESSIVE REHAB & STRENGTH,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RORI
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:973-902-2923
Mailing Address - Street 1:1306 AVALON SQ
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2883
Mailing Address - Country:US
Mailing Address - Phone:973-902-2923
Mailing Address - Fax:
Practice Address - Street 1:228 E JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2034
Practice Address - Country:US
Practice Address - Phone:973-902-2923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035362-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty