Provider Demographics
NPI:1881130250
Name:RCG PT PC
Entity type:Organization
Organization Name:RCG PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMON
Authorized Official - Middle Name:QUITO
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:III
Authorized Official - Credentials:PT
Authorized Official - Phone:551-358-9307
Mailing Address - Street 1:185 CANAL ST STE 504
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4537
Mailing Address - Country:US
Mailing Address - Phone:212-966-3040
Mailing Address - Fax:212-966-2944
Practice Address - Street 1:185 CANAL ST STE 504
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4537
Practice Address - Country:US
Practice Address - Phone:212-966-3040
Practice Address - Fax:212-966-2944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029714261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05877990Medicaid