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General NPI Number Information
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NPI Number | 1841415643
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY CARE OF NY, PC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 44 BONAIRE DR
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City | DIX HILLS
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State | NY
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Zip | 11746-6502
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Country | US
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Telephone | 516-635-5630
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Fax |
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Provider Business Mailing Address
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Address Line | 44 BONAIRE DR
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City | DIX HILLS
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State | NY
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Zip | 11746-6502
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Country | US
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Telephone | 516-635-5630
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Fax |
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Authorized Official
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Title or Position | OWNER PRESIDENT
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Name | RAMAK BAKHSHOUDEH
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Credential | P.T.
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Telephone | 516-635-5630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 015236-1
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License Number State | NY
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