Provider Demographics
NPI:1679663736
Name:A-1 COMMUNITY PHYSICAL MEDICINE & REHABILITATION, P.C.
Entity Type:Organization
Organization Name:A-1 COMMUNITY PHYSICAL MEDICINE & REHABILITATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAWNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-424-5151
Mailing Address - Street 1:7911 41ST AVE
Mailing Address - Street 2:A-108
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-1258
Mailing Address - Country:US
Mailing Address - Phone:718-424-5151
Mailing Address - Fax:718-424-9119
Practice Address - Street 1:7911 41ST AVE
Practice Address - Street 2:A-108
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1258
Practice Address - Country:US
Practice Address - Phone:718-424-5151
Practice Address - Fax:718-424-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY200303261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01592034Medicaid
NY04599Medicare ID - Type Unspecified
NY01592034Medicaid