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General NPI Number Information
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NPI Number | 1265675235
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Entity Type | Organization
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Legal Business Name | PRIME PHYSICAL THERAPY & REHABILITATION, P.C
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Dates
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Enumeration Date | 04/07/2009
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 6536 99TH STREET SUITE 1D
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City | REGO PARK
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State | NY
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Zip | 11374-4316
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Country | US
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Telephone | 718-897-6869
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Fax | 718-685-2101
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Provider Business Mailing Address
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Address Line | 6923 168TH STREET
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City | FRESH MEADOWS
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State | NY
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Zip | 11365
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Country | US
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Telephone | 347-730-4606
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Fax | 866-310-5525
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Authorized Official
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Title or Position | OWNER
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Name | GAVRIEL STANLEY
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Credential | PT
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Telephone | 718-897-6869
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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