Provider Demographics
NPI:1831321488
Name:ORTHO CARE PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:ORTHO CARE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLUBENKO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-743-7090
Mailing Address - Street 1:2511 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3950
Mailing Address - Country:US
Mailing Address - Phone:718-743-7090
Mailing Address - Fax:718-648-1328
Practice Address - Street 1:2511 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3950
Practice Address - Country:US
Practice Address - Phone:718-743-7090
Practice Address - Fax:718-648-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty