Healthcare Provider Details

I. General information

NPI: 1538328018
Provider Name (Legal Business Name): THE GRACE REHABILITATION AND PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 09/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1538 ROUTE 52
FISHKILL NY
12524-1621
US

IV. Provider business mailing address

1538 ROUTE 52
FISHKILL NY
12524-1621
US

V. Phone/Fax

Practice location:
  • Phone: 845-765-1037
  • Fax: 845-765-1038
Mailing address:
  • Phone: 845-765-1037
  • Fax: 845-765-1038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number014823-1
License Number StateNY

VIII. Authorized Official

Name: DR. JAMES B AKINWUNMI
Title or Position: DPT
Credential:
Phone: 845-765-1037