Provider Demographics
NPI:1336415090
Name:HOPE REHAB PT, PC
Entity Type:Organization
Organization Name:HOPE REHAB PT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESEDINT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:F
Authorized Official - Last Name:GAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:646-577-1054
Mailing Address - Street 1:2419 85TH ST
Mailing Address - Street 2:2ND FL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3503
Mailing Address - Country:US
Mailing Address - Phone:646-577-1054
Mailing Address - Fax:345-312-7543
Practice Address - Street 1:2995 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8390
Practice Address - Country:US
Practice Address - Phone:646-577-1054
Practice Address - Fax:646-200-5064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026764225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty