Provider Demographics
NPI:1952511701
Name:REHABILITATION AND PHYSICAL THERAPY CONSULTANT PC
Entity Type:Organization
Organization Name:REHABILITATION AND PHYSICAL THERAPY CONSULTANT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MUOYO
Authorized Official - Middle Name:
Authorized Official - Last Name:OKOME
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PT
Authorized Official - Phone:347-249-6501
Mailing Address - Street 1:724 E 18TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1801
Mailing Address - Country:US
Mailing Address - Phone:347-249-6501
Mailing Address - Fax:
Practice Address - Street 1:1641 BERGEN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2416
Practice Address - Country:US
Practice Address - Phone:347-249-6501
Practice Address - Fax:718-778-3083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8361-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAS 203OtherOXFORD PROVIDER ID #
NY5714653OtherFIRST HEALTH INS PROV #
NY77151OtherCAREPLUS PROVIDER ID #
NYPRIS #20304POtherHIP PROVIDER #
NY0038950103OtherHEALTHPLUS PROVIDERE #
NY1841263423OtherINDIVIDUAL NPI #
NY2326173OtherAETNA PROVIDER ID #
NY6699117OtherGHI PROVIDER #
NY815353OtherACN GROUP PROVIDER #
NY008361SOtherHEATHCARE PARTNERS PRVD #
NY00869397-001OtherUNITED HEALTHCARE ID #
NY008361NYOther1199SEIU PROVIDER ID #
NY=========OtherFEDERAL TAX ID #
NY2326173OtherAETNA PROVIDER ID #
NY=========OtherMETROPLUS PROVIDER ID #
NY008361SOtherHEATHCARE PARTNERS PRVD #
NY2326173OtherAETNA PROVIDER ID #
NY=========OtherMETROPLUS PROVIDER ID #