Healthcare Provider Details

I. General information

NPI: 1962964569
Provider Name (Legal Business Name): ACE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 04/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7411 37TH AVE
JACKSON HEIGHTS NY
11372-6339
US

IV. Provider business mailing address

27 LAUREL DR
GREAT NECK NY
11021-2826
US

V. Phone/Fax

Practice location:
  • Phone: 347-426-7773
  • Fax: 718-360-9680
Mailing address:
  • Phone: 347-426-7773
  • Fax: 516-570-6224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JAHID JAMES HOSSAIN
Title or Position: PRESIDENT
Credential:
Phone: 347-426-7773