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NPI Code Detail

MEDICARE: REGO PARK THERACARE PHYSICAL THERAPY P.C.

MEDICARE: REGO PARK THERACARE PHYSICAL THERAPY P.C.
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
1225100000XPhysical Therapist019595NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11881622207OTHERNYNPI INDIVIDUAL

General Provider Information

NPI Number : 1831275072
Entity Type Code : Organization
Provider Name (Legal Business Name) : REGO PARK THERACARE PHYSICAL THERAPY P.C.
Provider Business Mailing Address
First Line : 67 TRUXTON RD
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-6725
Country : US
Telephone Number : 631-940-0926
Fax Number : 631-940-0926
Provider Business Practice Location Address
First Line : 465 BLUE POINT RD STE A
Second Line :
City : FARMINGVILLE
State : NY
Zip : 11738-1839
Country : US
Telephone Number : 631-732-1386
Fax Number : 631-732-1544
Authorized Official
Title or Position : PRESIDENT
Name : MR. REX ONGOCO CRUZ
Credential : P.T.
Telephone Number : 631-732-1386
Provider Enumeration Date : 10/31/2006
Last Update Date : 08/22/2020

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