Provider Demographics
NPI:1568050821
Name:BULLSEYE PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:BULLSEYE PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FERDINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:540-522-2493
Mailing Address - Street 1:8202 229TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2154
Mailing Address - Country:US
Mailing Address - Phone:540-522-2493
Mailing Address - Fax:
Practice Address - Street 1:8202 229TH ST
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-2154
Practice Address - Country:US
Practice Address - Phone:154-052-2249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty