Advance Care Physical Therapy PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

029091 Issued in NY

Legal business name

ADVANCE CARE PHYSICAL THERAPY PC

Practice address

6360 98TH St
Ste A3
Rego Park, NY 11374-2238

Phone

(718) 664-0590

NPI assigned

Apr 11, 2007

Last updated

Aug 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Rafael Mastov, DPT

Title

President

Phone

(347) 255-8255

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597104000000",
    "number": "1952524290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 98TH ST",
            "address_2": "STE A3",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 98TH ST",
            "address_2": "STE A3",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113742238",
            "telephone_number": "718-664-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE CARE PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A",
        "authorized_official_last_name": "MASTOV",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "347-255-8255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "029091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Rego Park, NY
• Providers in Rego Park, 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 Aug 11, 2020; 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.