Provider Demographics
NPI:1619519972
Name:PROPEL PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:PROPEL PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-578-0361
Mailing Address - Street 1:15 WALDO AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1310
Mailing Address - Country:US
Mailing Address - Phone:516-578-0361
Mailing Address - Fax:516-621-0363
Practice Address - Street 1:15 WALDO AVE
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1310
Practice Address - Country:US
Practice Address - Phone:516-578-0361
Practice Address - Fax:516-621-0363
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-08
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty