Provider Demographics
NPI:1669779112
Name:PREFERRED CARE PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:PREFERRED CARE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FERDINAND
Authorized Official - Middle Name:DALUSONG
Authorized Official - Last Name:GUARIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-779-5588
Mailing Address - Street 1:6040 82ND ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-5335
Mailing Address - Country:US
Mailing Address - Phone:718-779-5588
Mailing Address - Fax:
Practice Address - Street 1:343 GOLD ST
Practice Address - Street 2:APT 907
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3055
Practice Address - Country:US
Practice Address - Phone:917-388-7491
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030254261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy