Provider Demographics
NPI:1922635218
Name:PROFICIENT REHAB CARE PT PLLC
Entity Type:Organization
Organization Name:PROFICIENT REHAB CARE PT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT
Authorized Official - Prefix:
Authorized Official - First Name:AMRO
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAKAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-701-3922
Mailing Address - Street 1:121 WINHAM AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 WINHAM AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4930
Practice Address - Country:US
Practice Address - Phone:347-302-6045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-25
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center