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General NPI Number Information
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NPI Number | 1336448505
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Entity Type | Organization
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Legal Business Name | SCORE REHABILITATION PHYSICAL AND OCCUPATIONAL THERAPY SERVICES, PLLC
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Dates
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Enumeration Date | 03/27/2011
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Last Update Date | 03/27/2011
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Provider Practice Location Address
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Address Line | 2307 30TH DR APT 1B
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City | ASTORIA
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State | NY
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Zip | 11102-3595
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Country | US
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Telephone | 646-450-2039
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Fax |
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Provider Business Mailing Address
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Address Line | 2307 30TH DR APT 1B
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City | ASTORIA
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State | NY
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Zip | 11102-3595
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Country | US
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Telephone | 646-450-2039
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MR. JAMES PATRICK SHIELDS
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Credential | PT
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Telephone | 646-450-2039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 015173-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 028564-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 029386-1
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License Number State | NY
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