Premier Medical Sports and Rehabilitation

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

PREMIER MEDICAL SPORTS AND REHABILITATION

Practice address

1955 Merrick Rd
Merrick, NY 11566-4642

Phone

(516) 623-3980

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Ahmed Elemam, M.D.

Title

Administrator

Phone

(516) 623-3980

Specialties & licenses 1

Addresses

Tax ID family

Premier Medical for Sport Rehabilitation PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Premier Medical for Sport & Rehabilitation, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Forest Hills, NY
  • NPI 1114255791
  NPD tax ID
• Premier Medical for Sport & Rehabilitation, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Brooklyn, NY
  • NPI 1366779787
  NPD tax ID

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457434102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 MERRICK RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 MERRICK RD",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115664642",
            "telephone_number": "516-623-3980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL SPORTS AND REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELEMAM",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-623-3980",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Plafker, OTR/L
• Martin Leonard Plutno, DC
• Michael C Poliseno, APN
• Polished Dental Care, PLLC
• Roseanne Prehoda, M.A. CCC-SLP
• Professional Occupational & Physical Therapy, PLLC
• Professional Occupational & Physical Therapy, PLLC
• Professional Ortho & Sports PT
• Professional Orthopedic and Sports Physical Therapy, P.C.
• Ellen Jeanne Proszak

• Clinic/Center in Merrick, NY
• Providers in Merrick, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.