Provider Demographics
NPI:1134274772
Name:RPT PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:RPT PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAIMONDI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-855-1543
Mailing Address - Street 1:335 COURT ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-4335
Mailing Address - Country:US
Mailing Address - Phone:718-855-1543
Mailing Address - Fax:718-855-0893
Practice Address - Street 1:335 COURT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-4335
Practice Address - Country:US
Practice Address - Phone:718-855-1543
Practice Address - Fax:718-855-0893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYC17426225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ3W3F1Medicare PIN