Healthcare Provider Details

I. General information

NPI: 1407964182
Provider Name (Legal Business Name): QUALITY CARE PHYSICAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

752 WILLOUGHBY AVE FL 1
BROOKLYN NY
11206-7032
US

IV. Provider business mailing address

752 WILLOUGHBY AVE FL 1
BROOKLYN NY
11206-7032
US

V. Phone/Fax

Practice location:
  • Phone: 718-854-9055
  • Fax: 347-382-6056
Mailing address:
  • Phone: 718-854-9055
  • Fax: 347-382-6056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSE SANDY HAYAG BUCO
Title or Position: PRESIDENT
Credential: PT
Phone: 718-854-9055