Provider Demographics
NPI:1780077412
Name:PHYSICAL THERAPY REHABILITATION NEW YORK CITY, P.C.
Entity type:Organization
Organization Name:PHYSICAL THERAPY REHABILITATION NEW YORK CITY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERRY
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:CASTELLVI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:917-741-4754
Mailing Address - Street 1:10008 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2017
Mailing Address - Country:US
Mailing Address - Phone:917-741-4754
Mailing Address - Fax:718-228-2820
Practice Address - Street 1:10008 87TH AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2017
Practice Address - Country:US
Practice Address - Phone:917-741-4754
Practice Address - Fax:718-228-2820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0122141252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency