Provider Demographics
NPI:1740886233
Name:GIMBO CORRE PHYSICAL THERAPY REHABILITATION SERVICES, PC.
Entity type:Organization
Organization Name:GIMBO CORRE PHYSICAL THERAPY REHABILITATION SERVICES, PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GIMBO JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:CORRE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-806-7706
Mailing Address - Street 1:55 CLINTON RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-6340
Mailing Address - Country:US
Mailing Address - Phone:347-806-7706
Mailing Address - Fax:
Practice Address - Street 1:7708 BROADWAY
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-1927
Practice Address - Country:US
Practice Address - Phone:347-806-7706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-09
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy