Provider Demographics
NPI:1538328018
Name:THE GRACE REHABILITATION AND PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:THE GRACE REHABILITATION AND PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:AKINWUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-765-1037
Mailing Address - Street 1:1538 ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1621
Mailing Address - Country:US
Mailing Address - Phone:845-765-1037
Mailing Address - Fax:845-765-1038
Practice Address - Street 1:1538 ROUTE 52
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1621
Practice Address - Country:US
Practice Address - Phone:845-765-1037
Practice Address - Fax:845-765-1038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014823-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy