MEDICARE: OM PHYSICAL THERAPY PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	032378	NY

General Provider Information

NPI Number	:	1093150955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OM PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	PO BOX 40217
Second Line	:
City	:	GLEN OAKS
State	:	NY
Zip	:	11004-0217
Country	:	US
Telephone Number	:	929-379-3291
Fax Number	:	929-379-3292

Provider Business Practice Location Address
First Line	:	8902 SPRINGFIELD BLVD
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-2514
Country	:	US
Telephone Number	:	929-379-3291
Fax Number	:	929-379-3292

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	HITENKUMAR PATEL
Credential	:	RPT
Telephone Number	:	718-484-9393

Provider Enumeration Date	:	05/06/2013
Last Update Date	:	11/18/2025

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