Healthcare Provider Details

I. General information

NPI: 1316227671
Provider Name (Legal Business Name): PROHEALTH REHABILITATION PT,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 OCEAN AVE SUITE 1
EAST ROCKAWAY NY
11518-1208
US

IV. Provider business mailing address

88 GREENWAY W
MANHASSET HILLS NY
11040-2225
US

V. Phone/Fax

Practice location:
  • Phone: 516-881-7800
  • Fax: 516-385-2574
Mailing address:
  • Phone: 516-280-2923
  • Fax: 516-385-2574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: KHRISTINA FERIL
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: PT,DPT
Phone: 516-280-2923