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General NPI Number Information
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NPI Number | 1831455963
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Entity Type | Organization
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Legal Business Name | QUALITY REHAB MEDICAL PLLC
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 6203 FORT HAMILTON PKWY
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City | BROOKLYN
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State | NY
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Zip | 11219-5116
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Country | US
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Telephone | 718-745-3310
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Fax |
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Provider Business Mailing Address
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Address Line | 6203 FORT HAMILTON PKWY
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City | BROOKLYN
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State | NY
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Zip | 11219-5116
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Country | US
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Telephone | 718-745-3310
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MINGXU XU
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Credential | M.D.
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Telephone | 602-710-6834
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 260294
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License Number State | NY
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