Provider Demographics
NPI: | 1245003169 |
---|---|
Name: | NEAR ME PHYSICAL THERAPY, P.C. |
Entity type: | Organization |
Organization Name: | NEAR ME PHYSICAL THERAPY, P.C. |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | SAMI |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SEO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPT |
Authorized Official - Phone: | 718-359-1004 |
Mailing Address - Street 1: | 4029 235TH ST FL 2 |
Mailing Address - Street 2: | |
Mailing Address - City: | DOUGLASTON |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 11363-1509 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 718-359-1004 |
Mailing Address - Fax: | 718-691-4053 |
Practice Address - Street 1: | 4029 235TH ST FL 2 |
Practice Address - Street 2: | |
Practice Address - City: | DOUGLASTON |
Practice Address - State: | NY |
Practice Address - Zip Code: | 11363-1509 |
Practice Address - Country: | US |
Practice Address - Phone: | 718-359-1004 |
Practice Address - Fax: | 718-691-4053 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-11-02 |
Last Update Date: | 2024-12-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Single Specialty |