Provider Demographics
NPI:1912346644
Name:GFM REHAB PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:GFM REHAB PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:FARYDE
Authorized Official - Last Name:MATERON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-645-0779
Mailing Address - Street 1:56 WYCKOFF ST
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-2836
Mailing Address - Country:US
Mailing Address - Phone:516-597-4020
Mailing Address - Fax:516-597-4021
Practice Address - Street 1:56 WYCKOFF ST
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-2836
Practice Address - Country:US
Practice Address - Phone:516-597-4020
Practice Address - Fax:516-597-4021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-15
Last Update Date:2013-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014794-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health