Imperial Rehab PT PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

032839 Issued in NY

Legal business name

IMPERIAL REHAB PT PC

Practice address

21808 Hempstead Ave
2 FL
Queens Village, NY 11429-1235

Phone

(631) 805-8655

Fax

(718) 998-9059

NPI assigned

Feb 5, 2014

Organization subpart

No

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

Authorized official

Name

Khaled Aaga, PT

Title

President

Phone

(631) 805-8655

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391558400000",
    "number": "1730503178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BAY 17TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112143706",
            "telephone_number": "631-805-8655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21808 HEMPSTEAD AVE",
            "address_2": "2 FL",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114291235",
            "telephone_number": "631-805-8655",
            "fax_number": "718-998-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL REHAB PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-05",
        "last_updated": "2014-02-05",
        "status": "A",
        "authorized_official_last_name": "AAGA",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-805-8655",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "032839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "032839",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Queens Village, NY
• Providers in Queens Village, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.