Provider Demographics
NPI:1245927524
Name:G.N.N REHAB PT PC
Entity type:Organization
Organization Name:G.N.N REHAB PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIOUS
Authorized Official - Middle Name:NATHAN WESSA
Authorized Official - Last Name:NASHED
Authorized Official - Suffix:
Authorized Official - Credentials:PT DPT CLT
Authorized Official - Phone:925-567-4671
Mailing Address - Street 1:350 HERB HILL RD APT 313H
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-4407
Mailing Address - Country:US
Mailing Address - Phone:925-567-4671
Mailing Address - Fax:
Practice Address - Street 1:4226A 3RD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4502
Practice Address - Country:US
Practice Address - Phone:925-567-4671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy