Provider Demographics
NPI:1841986445
Name:DOWNTOWN BROOKLYN PT PC
Entity type:Organization
Organization Name:DOWNTOWN BROOKLYN PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAQDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:929-435-8403
Mailing Address - Street 1:PO BOX 740039
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-0039
Mailing Address - Country:US
Mailing Address - Phone:929-435-8403
Mailing Address - Fax:
Practice Address - Street 1:6937 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7265
Practice Address - Country:US
Practice Address - Phone:929-435-8403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy