Healthcare Provider Details

I. General information

NPI: 1053921197
Provider Name (Legal Business Name): PARADIGM MEDICAL REHABILITATION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2020
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 OLD COUNTRY RD
PLAINVIEW NY
11803-4914
US

IV. Provider business mailing address

334 HILLSIDE DR S
NEW HYDE PARK NY
11040-2720
US

V. Phone/Fax

Practice location:
  • Phone: 516-719-3000
  • Fax: 770-502-6792
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KUNAL DEVDATT OAK
Title or Position: PRESIDENT
Credential: DO
Phone: 718-598-6808