MEDICARE: REHAB SYNERGY PT, 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

General Provider Information

NPI Number	:	1811322894
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB SYNERGY PT, PC.

Provider Business Mailing Address
First Line	:	3530 64TH ST
Second Line	:
City	:	WOODSIDE
State	:	NY
Zip	:	11377-2354
Country	:	US
Telephone Number	:	914-426-7423
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 64TH ST
Second Line	:
City	:	WOODSIDE
State	:	NY
Zip	:	11377-2354
Country	:	US
Telephone Number	:	914-426-7423
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPY
Name	:	MR. BASILIO LOPEZ
Credential	:	PT
Telephone Number	:	914-426-7423

Provider Enumeration Date	:	09/09/2013
Last Update Date	:	05/11/2024

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