New York Rehab Specialist, PC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

030067 Issued in NY

Legal business name

NEW YORK REHAB SPECIALIST, PC

Practice address

4621 Fort Hamilton Pkwy
Brooklyn, NY 11219-2414

Phone

(347) 777-9707

NPI assigned

Dec 29, 2009

Organization subpart

No

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

Authorized official

Name

Marievic Ebora Villanueva, PT

Title

Manager

Phone

(347) 777-9707

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Marievic Balaag Ebora Fernando, PT, DPT

  • Physical Therapist
  • Forest Hills, NY
  • NPI 1629236278
  NPD (past)

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1720318546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6815 SELFRIDGE ST",
            "address_2": "2H",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113755747",
            "telephone_number": "347-777-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4621 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112192414",
            "telephone_number": "347-777-9707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK REHAB SPECIALIST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "VILLANUEVA",
        "authorized_official_first_name": "MARIEVIC",
        "authorized_official_middle_name": "EBORA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "347-777-9707",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "030067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02976121",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New York Recovery DME Corp
• New York Recovery Services LCSW PC
• New York Recovery Services LCSW PC
• New York Rehab and Lower Extremity Services
• New York Rehab PT PC
• New York Robotic Thoracic and Endovascular Surgeons PC
• New York Senior Services Inc
• New York Senior Services Inc
• New York Service Network
• New York Service Network

• Physical Therapy Clinic/Center in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physical Therapy Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.