Provider Demographics
NPI:1134336357
Name:HEALTH ONE PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:HEALTH ONE PHYSICAL THERAPY, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARZIC
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:718-505-0707
Mailing Address - Street 1:37-17 90TH STREET
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7868
Mailing Address - Country:US
Mailing Address - Phone:718-505-0707
Mailing Address - Fax:718-505-9199
Practice Address - Street 1:37-17 90TH STREET
Practice Address - Street 2:1ST FLOOR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7868
Practice Address - Country:US
Practice Address - Phone:718-505-0707
Practice Address - Fax:718-505-9199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2009-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015377-1261QP3300X, 261QR0400X, 261QR0401X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02229445Medicaid
NYP5859ZMedicare UPIN