Life Rehab PT PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

037263 Issued in NY

Legal business name

LIFE REHAB PT PC

Practice address

3910 Church Ave
Brooklyn, NY 11203-2915

Phone

(631) 746-8750

NPI assigned

Apr 25, 2018

Organization subpart

No

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

Authorized official

Name

Mohamed Aly

Title

Owner

Phone

(631) 746-8750

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1821586900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 211026",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112217026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3910 CHURCH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032915",
            "telephone_number": "631-746-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE REHAB PT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "ALY",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-746-8750"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "037263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Brooklyn, NY
• Providers in Brooklyn, 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 Apr 25, 2018; 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.