Provider Demographics
NPI:1619202348
Name:NEW VISION PHYSICAL THERAPY & REHAB PC
Entity Type:Organization
Organization Name:NEW VISION PHYSICAL THERAPY & REHAB PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANJUM
Authorized Official - Middle Name:
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-739-2200
Mailing Address - Street 1:24 FAIRFAX ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3515
Mailing Address - Country:US
Mailing Address - Phone:718-536-8548
Mailing Address - Fax:718-526-2830
Practice Address - Street 1:8742 169TH ST
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-3632
Practice Address - Country:US
Practice Address - Phone:718-739-2200
Practice Address - Fax:718-526-2830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-14
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022953174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty