Provider Demographics
NPI:1952885980
Name:NBC HEALTH PHYSICAL THERAPY P.C.
Entity type:Organization
Organization Name:NBC HEALTH PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NATHANIEL BREX
Authorized Official - Middle Name:ROA
Authorized Official - Last Name:CAYETUNA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-714-1392
Mailing Address - Street 1:13668 ROOSEVELT AVE RM 802
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5510
Mailing Address - Country:US
Mailing Address - Phone:718-886-6850
Mailing Address - Fax:718-886-6037
Practice Address - Street 1:13668 ROOSEVELT AVE RM 802
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5510
Practice Address - Country:US
Practice Address - Phone:718-886-6850
Practice Address - Fax:718-886-6037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-15
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty