MEDICARE: PHYSICAL THERAPY LINK 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	225100000X	Physical Therapist	031825	NY

General Provider Information

NPI Number	:	1609146943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY LINK PC

Provider Business Mailing Address
First Line	:	49 WOODCREST RD
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10303-1730
Country	:	US
Telephone Number	:	718-370-8830
Fax Number	:

Provider Business Practice Location Address
First Line	:	396 ARLENE ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3226
Country	:	US
Telephone Number	:	718-370-8830
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FATEN ZAKY HASSAN
Credential	:	PT
Telephone Number	:	718-370-8830

Provider Enumeration Date	:	01/04/2012
Last Update Date	:	01/04/2012

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Directions to “PHYSICAL THERAPY LINK PC ” Practice Location

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