Healthcare Provider Details

I. General information

NPI: 1386557635
Provider Name (Legal Business Name): RAAH PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15744 20TH RD UNIT 2
WHITESTONE NY
11357-3828
US

IV. Provider business mailing address

15744 20TH RD UNIT 2
WHITESTONE NY
11357-3828
US

V. Phone/Fax

Practice location:
  • Phone: 718-200-5368
  • Fax:
Mailing address:
  • Phone: 718-200-5368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: LEAH VILLANUEVA
Title or Position: PRESIDENT
Credential: PT
Phone: 718-200-5368