Professional Rehab P.T., P.C.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

019908 Issued in NY

Legal business name

PROFESSIONAL REHAB P.T., P.C.

Practice address

700 Patchogue Yaphank Rd Ste 49
Medford, NY 11763-2239

Phone

(631) 775-7580

Fax

(631) 775-7853

NPI assigned

Aug 19, 2007

Organization subpart

No

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

Authorized official

Name

Muhammad Imran, P.T.NPI 1366565616

Title

President

Phone

(631) 775-7850

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

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

• Muhammad Imran, P.T.

  • Physical Therapist
  • Medford, NY
  • NPI 1366565616
  Medicare reassignment NPD Authorized official
• Sang H Song Sr., MD

  • Physical Medicine & Rehabilitation Physician
  • Hauppauge, NY
  • NPI 1093702425
  NPD (past)

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

{
    "created_epoch": "1187481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428278400000",
    "number": "1871786327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 PATCHOGUE YAPHANK RD STE 49",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632239",
            "telephone_number": "631-775-7850",
            "fax_number": "631-775-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 PATCHOGUE YAPHANK RD STE 49",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117632239",
            "telephone_number": "631-775-7580",
            "fax_number": "631-775-7853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL REHAB P.T., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-19",
        "last_updated": "2015-04-06",
        "status": "A",
        "authorized_official_last_name": "IMRAN",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-775-7850",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NY",
            "license": "019908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Principe, RN
• Priolo and Berns Chiropractic PLLC
• Kristan Probeck, RN, MS, ANP
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy, P.C.
• Progressive Rehab Management Corporation
• Provident Health Partners Inc.
• Casandra J Prygocki, CRNA
• Regina Przywara, LCSW
• Quantix Labs

• Physical Therapy Clinic/Center in Medford, NY
• Providers in Medford, 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 Apr 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.