Provider Demographics
NPI:1912294430
Name:PHYSICAL THERAPY REHAB PLUS, P.C.
Entity Type:Organization
Organization Name:PHYSICAL THERAPY REHAB PLUS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:SALL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:631-476-4600
Mailing Address - Street 1:1970 ROUTE 112
Mailing Address - Street 2:SUITE 6
Mailing Address - City:CORAM
Mailing Address - State:NY
Mailing Address - Zip Code:11727-2300
Mailing Address - Country:US
Mailing Address - Phone:631-476-4600
Mailing Address - Fax:631-476-8236
Practice Address - Street 1:1970 ROUTE 112
Practice Address - Street 2:SUITE 6
Practice Address - City:CORAM
Practice Address - State:NY
Practice Address - Zip Code:11727-2300
Practice Address - Country:US
Practice Address - Phone:631-476-4600
Practice Address - Fax:631-476-8236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032930-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy