Healthcare Provider Details

I. General information

NPI: 1639889215
Provider Name (Legal Business Name): KEN ERBVIN RINT SOSA PT, MOH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2022
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 E TREMONT AVE
BRONX NY
10461-5726
US

IV. Provider business mailing address

1657 PILGRIM AVE FL 2
BRONX NY
10461-4807
US

V. Phone/Fax

Practice location:
  • Phone: 212-273-6100
  • Fax:
Mailing address:
  • Phone: 862-384-9844
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number04152601
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: