Provider Demographics
NPI:1982779377
Name:QUEENS PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:QUEENS PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARVEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NGITNGIT
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:718-352-5200
Mailing Address - Street 1:13215A 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-2001
Mailing Address - Country:US
Mailing Address - Phone:718-352-5200
Mailing Address - Fax:718-352-0105
Practice Address - Street 1:13215A 14TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-2001
Practice Address - Country:US
Practice Address - Phone:718-352-5200
Practice Address - Fax:718-352-0105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015515-1261QP2000X
NY022357-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYDA0370OtherRAILROAD MEDICARE
NY=========OtherBEECH STREET
NY=========OtherHORIZON HEALTHCARE
NY=========OtherMAGNACARE
NY=========OtherEMPIRE PLAN
NYDA0370OtherRAILROAD MEDICARE
NY=========OtherBEECH STREET