Provider Demographics
NPI:1649961772
Name:CARP PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:CARP PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLENE ARK
Authorized Official - Middle Name:REYES
Authorized Official - Last Name:PIAD
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-442-8813
Mailing Address - Street 1:8402 143RD ST APT 302
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2657
Mailing Address - Country:US
Mailing Address - Phone:646-704-2190
Mailing Address - Fax:
Practice Address - Street 1:399 LAKE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-2640
Practice Address - Country:US
Practice Address - Phone:718-442-8813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty