Provider Demographics
NPI:1821158304
Name:BI COUNTY PHYSICAL THERAPY AND REHABILITATION LLP
Entity Type:Organization
Organization Name:BI COUNTY PHYSICAL THERAPY AND REHABILITATION LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROWELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT OCS
Authorized Official - Phone:516-739-5503
Mailing Address - Street 1:397 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:WILLISTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11596
Mailing Address - Country:US
Mailing Address - Phone:516-739-5503
Mailing Address - Fax:516-739-5565
Practice Address - Street 1:397 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:WILLISTON PARK
Practice Address - State:NY
Practice Address - Zip Code:11596
Practice Address - Country:US
Practice Address - Phone:516-739-5503
Practice Address - Fax:516-739-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01316001261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ36163Medicare PIN
NYP00061516Medicare PIN
NY04760Medicare ID - Type Unspecified
NYWET581Medicare PIN