Healthcare Provider Details

I. General information

NPI: 1073682886
Provider Name (Legal Business Name): PAIN RELIEF MEDICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 22 ROCKAWAY BLVD
SO OZONE PARK NY
11420
US

IV. Provider business mailing address

131 22 ROCKAWAY BLVD
SO OZONE PARK NY
11420
US

V. Phone/Fax

Practice location:
  • Phone: 718-659-7166
  • Fax: 718-529-5930
Mailing address:
  • Phone: 718-659-7166
  • Fax: 718-529-5930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMIL ABRAHAM
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 718-659-7166