Acosta Physical Therapy PC
Organization Active NPI Physical Therapy Clinic/Center · Fresh Meadows, NY
NPI 1922345271 · NPPES record last updated Sep 5, 2014
Key facts
- NPI
- 1922345271
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 028426-1 (NY)
- Legal business name
- ACOSTA PHYSICAL THERAPY PC
- Practice address
- 6134 188TH St
Suite 208
Fresh Meadows, NY 11365-2719 - Phone
- (718) 264-1979
- Fax
- (718) 254-3020
- NPI assigned
- Jan 7, 2013
- Organization subpart
- No
Authorized official
- Name
- Alvaro A Acosta, DPT
- Title
- President
- Phone
- (516) 312-0082
Practitioners 1
-
Alvaro Acosta, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130416000290 | NY | Part B Supplier - Clinic/Group Practice | 6103062203 |
Receives reassigned benefits from 1 practitioner Practice locations: Fresh Meadows, NY |
National Provider Directory
Locations
6134 188th St
Ste 208
Fresh Meadows, NY 11365
Phone (516) 312-0082
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 028426-1 | NY | Yes |
Addresses
Primary practice location
6134 188TH St
Suite 208
Fresh Meadows, NY 11365-2719
Mailing address
219-32 64TH Avenue
3Rd Floor
Oakland Gardens, NY 11364
Phone (516) 312-0082
Other providers in Fresh Meadows, NY
- Rachelle Abramovitz
- Avram L. Abramowitz
- Thalia Abreu
- Sundus Abudayyeh
- Santa Magdalena Abuzid
- Alvaro Acosta
- Elena I Acosta
- Frantzie Emmanuelle Adam
- Mina Fawzy Adams
- Chaya Shira Adler
All providers in Fresh Meadows, NY · Physical Therapy Clinic/Center in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.