Provider Demographics
NPI:1457795791
Name:REHABILITIES PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:REHABILITIES PHYSICAL THERAPY PLLC
Other - Org Name:LEAP PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MITZI
Authorized Official - Middle Name:MALILAY
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-338-5327
Mailing Address - Street 1:55 POST AVE
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-4361
Mailing Address - Country:US
Mailing Address - Phone:516-338-5327
Mailing Address - Fax:516-338-5320
Practice Address - Street 1:55 POST AVE
Practice Address - Street 2:FLOOR 1
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-4361
Practice Address - Country:US
Practice Address - Phone:516-338-5327
Practice Address - Fax:516-338-5320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021290261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy