Provider Demographics
NPI:1023899002
Name:FUNCTIONAL HEALTH INCORPORATED
Entity type:Organization
Organization Name:FUNCTIONAL HEALTH INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER-OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY KAHRL
Authorized Official - Middle Name:I
Authorized Official - Last Name:BIGORNIA
Authorized Official - Suffix:
Authorized Official - Credentials:OT
Authorized Official - Phone:646-236-6898
Mailing Address - Street 1:8015 231ST ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2107
Mailing Address - Country:US
Mailing Address - Phone:646-236-6898
Mailing Address - Fax:718-338-2695
Practice Address - Street 1:3130 GRAND CONCOURSE STE 1E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1263
Practice Address - Country:US
Practice Address - Phone:212-203-3201
Practice Address - Fax:718-338-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06841845Medicaid
NY1083083539OtherIND NPI