Provider Demographics
NPI:1629480702
Name:REHAB CORE PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:REHAB CORE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HARLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAWA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-354-9157
Mailing Address - Street 1:1039 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2157
Mailing Address - Country:US
Mailing Address - Phone:646-354-9157
Mailing Address - Fax:
Practice Address - Street 1:1039 MARCUS AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2157
Practice Address - Country:US
Practice Address - Phone:646-354-9157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-23
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy