Provider Demographics
NPI:1558097170
Name:REHABILITATION OF THE CITY PT PC
Entity type:Organization
Organization Name:REHABILITATION OF THE CITY PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELANANY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-604-6733
Mailing Address - Street 1:32 DAWSON CIR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3823
Mailing Address - Country:US
Mailing Address - Phone:929-435-0990
Mailing Address - Fax:718-745-2022
Practice Address - Street 1:6919 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1501
Practice Address - Country:US
Practice Address - Phone:929-435-0990
Practice Address - Fax:718-745-2022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty