Provider Demographics
NPI:1831331909
Name:REHAB ISLAND PHYSICAL THERAPY
Entity type:Organization
Organization Name:REHAB ISLAND PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARAKAT
Authorized Official - Middle Name:MOHAMED
Authorized Official - Last Name:ZIHIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-641-6020
Mailing Address - Street 1:25 PALISADE ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-4711
Mailing Address - Country:US
Mailing Address - Phone:718-720-1504
Mailing Address - Fax:
Practice Address - Street 1:250 VAN BRUNT ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-1211
Practice Address - Country:US
Practice Address - Phone:718-222-0016
Practice Address - Fax:718-222-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-03
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014891225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty