Healthcare Provider Details

I. General information

NPI: 1326384561
Provider Name (Legal Business Name): HEALING IN MOTION PHYSICAL THERAPY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2012
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8834 161ST ST
JAMAICA NY
11432-4040
US

IV. Provider business mailing address

8450 169TH ST APT 415
JAMAICA NY
11432-2049
US

V. Phone/Fax

Practice location:
  • Phone: 718-314-6763
  • Fax: 347-923-3217
Mailing address:
  • Phone: 718-314-6763
  • Fax: 347-923-3217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number018530
License Number StateNY

VIII. Authorized Official

Name: DR. IMRUL KABIR
Title or Position: PRESIDENT
Credential: P.T., D.P.T.
Phone: 718-314-6763