Provider Demographics
NPI:1922495910
Name:BRIGHT S.I. PHYSICAL THERAPY P.C
Entity Type:Organization
Organization Name:BRIGHT S.I. PHYSICAL THERAPY P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAGDY
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:ELMADBOLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHYSICAL THERAPIST
Authorized Official - Phone:718-351-2160
Mailing Address - Street 1:2052 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2583
Mailing Address - Country:US
Mailing Address - Phone:718-351-2160
Mailing Address - Fax:718-667-7279
Practice Address - Street 1:2052 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2583
Practice Address - Country:US
Practice Address - Phone:718-351-2160
Practice Address - Fax:718-667-7279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty