Prime Physical Therapy & Rehabilitation PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

029384 Issued in NY

Legal business name

PRIME PHYSICAL THERAPY & REHABILITATION PC

Practice address

22 W 21St St Ste 404
New York, NY 10010-6936

Phone

(718) 304-4898

NPI assigned

Oct 6, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stanley Gavriel, D.P.T.

Title

President

Phone

(718) 304-4898

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Prime Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Prime Physical Therapy & Rehabilitation, P.C

  • Physical Therapy Clinic/Center
  • Rego Park, NY
  • NPI 1265675235
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1073764262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 W 21ST ST STE 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 W 21ST ST STE 404",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100106936",
            "telephone_number": "718-304-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PHYSICAL THERAPY & REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "GAVRIEL",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-304-4898",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851561328",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Primavera, PA-C
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• Prime Care, Inc.
• Prime Essentials LLC
• Prime Pharmacy, Inc.
• Prime Social Day Care
• Sabella Sandra Prime, PMHNP
• Primecare Medical Solutions, LLC
• Primeorthmed Supplies LLC
• Primeorthomed Supplies LLC

• All providers in New York, NY
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.