Healthcare Provider Details

I. General information

NPI: 1154432920
Provider Name (Legal Business Name): REHAB-PRO OF CONGERS P.T.PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 N ROUTE 303 STE 15
CONGERS NY
10920-1425
US

IV. Provider business mailing address

285 N ROUTE 303 STE 15
CONGERS NY
10920-1425
US

V. Phone/Fax

Practice location:
  • Phone: 845-268-8998
  • Fax: 845-268-8999
Mailing address:
  • Phone: 845-268-8998
  • Fax: 845-268-8999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number016209
License Number StateNY

VIII. Authorized Official

Name: MRS. IWONA JOLANTA TYBINKOWSKA
Title or Position: OWNER
Credential: P.T.
Phone: 845-268-8998