Provider Demographics
NPI:1689316770
Name:EM PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Entity Type:Organization
Organization Name:EM PHYSICAL AND OCCUPATIONAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAVIK
Authorized Official - Middle Name:PRAFUL
Authorized Official - Last Name:SHETH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:718-308-5225
Mailing Address - Street 1:2244 JACKSON AVE APT 820
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-9410
Mailing Address - Country:US
Mailing Address - Phone:718-308-5225
Mailing Address - Fax:201-591-7839
Practice Address - Street 1:10615 QUEENS BLVD # B11
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4301
Practice Address - Country:US
Practice Address - Phone:646-389-1161
Practice Address - Fax:201-591-7839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-10
Last Update Date:2023-12-21
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