Healthcare Provider Details

I. General information

NPI: 1821158304
Provider Name (Legal Business Name): BI COUNTY PHYSICAL THERAPY AND REHABILITATION LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

397 WILLIS AVE
WILLISTON PARK NY
11596
US

IV. Provider business mailing address

397 WILLIS AVE
WILLISTON PARK NY
11596
US

V. Phone/Fax

Practice location:
  • Phone: 516-739-5503
  • Fax: 516-739-5565
Mailing address:
  • Phone: 516-739-5503
  • Fax: 516-739-5565

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number01316001
License Number StateNY

VIII. Authorized Official

Name: GLEN W ROWELL
Title or Position: PHYSICAL THERAPIST
Credential: PT DPT OCS
Phone: 516-739-5503