Provider Demographics
NPI:1134362494
Name:T&M REHAB PT PC
Entity type:Organization
Organization Name:T&M REHAB PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMER
Authorized Official - Middle Name:
Authorized Official - Last Name:GAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-941-5400
Mailing Address - Street 1:7211 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5354
Mailing Address - Country:US
Mailing Address - Phone:718-941-5400
Mailing Address - Fax:718-941-5405
Practice Address - Street 1:2020 CORTELYOU RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-5904
Practice Address - Country:US
Practice Address - Phone:718-941-5400
Practice Address - Fax:718-641-5405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-15
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY026050OtherLICENSE