MEDICARE: REBOUND PHYSICAL THERAPY AND REHABILITATION SERVICES PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	21299	NY

General Provider Information

NPI Number	:	1053478925
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REBOUND PHYSICAL THERAPY AND REHABILITATION SERVICES PC

Provider Business Mailing Address
First Line	:	3201 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4236
Country	:	US
Telephone Number	:	718-382-9505
Fax Number	:	718-382-9527

Provider Business Practice Location Address
First Line	:	3201 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4236
Country	:	US
Telephone Number	:	718-382-9505
Fax Number	:	718-382-9527

Authorized Official
Title or Position	:	CO-OWNER
Name	:	SAM MOLOS
Credential	:	M.S.P.T.
Telephone Number	:	718-382-9505

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	03/24/2015

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