Provider Demographics
NPI:1265761464
Name:PHYSICAL THERAPY LINK PC
Entity type:Organization
Organization Name:PHYSICAL THERAPY LINK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FATEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-698-8487
Mailing Address - Street 1:49 WOODCREST RD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-1730
Mailing Address - Country:US
Mailing Address - Phone:718-698-8487
Mailing Address - Fax:718-998-9059
Practice Address - Street 1:49 WOODCREST RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-1730
Practice Address - Country:US
Practice Address - Phone:718-698-8487
Practice Address - Fax:718-998-9059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty