Richmond Physical Therapy, PC

Organization Active NPI Physical Therapist · Staten Island, NY

NPI 1053644153 · NPPES record last updated Jul 24, 2024

Key facts

NPI
1053644153
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
License
28520-1 (NY)
Legal business name
RICHMOND PHYSICAL THERAPY, PC
Practice address
1785 Forest Ave
Staten Island, NY 10303-2107
Phone
(646) 820-5669
NPI assigned
Sep 8, 2009
Organization subpart
No

Authorized official

Name
Madhurani Prakash Mahajan NPI 1285769588
Title
Director
Phone
(646) 820-5669

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in NY, NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120308000224 NY Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3577722727 Receives reassigned benefits from 17 practitioners
Practice locations: Staten Island, NY
O20221031002797 NJ Part B Supplier - Clinic/Group Practice 3577722727 Receives reassigned benefits from 3 practitioners
Practice locations: Matawan, NJ

National Provider Directory

Locations

3996 County Road 516
Ste 101
Matawan, NJ 07747
Phone (732) 391-8100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
225100000X 28520-1 NY Yes

Addresses

Primary practice location

1785 Forest Ave
Staten Island, NY 10303-2107

Mailing address

1785 Forest Ave
Staten Island, NY 10303-2107
Phone (646) 820-5669

Other practice location 1

158 Main St Ste 100
Matawan, NJ 07747-3178
Phone (646) 820-5669

Other practice location 2

3377 Richmond Ave
Staten Island, NY 10312-2025
Phone (646) 820-5669

Other practice location 3

2627 Hylan Blvd Ste A2
Staten Island, NY 10306-4344
Phone (646) 820-5669

Other providers in Staten Island, NY

All providers in Staten Island, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.