Provider Demographics
NPI:1891307286
Name:VIM PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:VIM PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SOHIB
Authorized Official - Middle Name:
Authorized Official - Last Name:KOTB
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:929-422-3804
Mailing Address - Street 1:77 PROSPECT AVE APT 3A
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1923
Mailing Address - Country:US
Mailing Address - Phone:929-422-3804
Mailing Address - Fax:
Practice Address - Street 1:1565 W 11TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6245
Practice Address - Country:US
Practice Address - Phone:929-422-3804
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty