Provider Demographics
NPI:1689083610
Name:RAPHA OFFICE & HOME PHYSICAL THERAPY SERVICES P.C.
Entity Type:Organization
Organization Name:RAPHA OFFICE & HOME PHYSICAL THERAPY SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMKUTTY
Authorized Official - Middle Name:
Authorized Official - Last Name:CYRIAC
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-560-1734
Mailing Address - Street 1:1039 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2939
Mailing Address - Country:US
Mailing Address - Phone:917-560-1734
Mailing Address - Fax:516-352-0353
Practice Address - Street 1:1039 N 5TH ST
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-2939
Practice Address - Country:US
Practice Address - Phone:917-560-1734
Practice Address - Fax:516-352-0353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027084174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty