Provider Demographics
NPI:1992846729
Name:IN-MOTION PHYSICAL THERAPY,PC
Entity Type:Organization
Organization Name:IN-MOTION PHYSICAL THERAPY,PC
Other - Org Name:HANDS-ON EMG TESTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIMITRIOS
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSTOPOULOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT,PHD
Authorized Official - Phone:718-707-6970
Mailing Address - Street 1:3636 33RD ST STE 403
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-2329
Mailing Address - Country:US
Mailing Address - Phone:718-707-6970
Mailing Address - Fax:718-707-6977
Practice Address - Street 1:3270 31ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-2643
Practice Address - Country:US
Practice Address - Phone:718-626-2699
Practice Address - Fax:718-626-0923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011188-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06326GMedicare UPIN