1326384561 NPI number — HEALING IN MOTION PHYSICAL THERAPY, P.C.

Table of content: (NPI 1326384561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326384561 NPI number — HEALING IN MOTION PHYSICAL THERAPY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALING IN MOTION PHYSICAL THERAPY, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326384561
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8450 169TH ST
Provider Second Line Business Mailing Address:
APT 415
Provider Business Mailing Address City Name:
JAMAICA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11432-2049
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-314-6763
Provider Business Mailing Address Fax Number:
347-923-3217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8834 161ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11432-4040
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-314-6763
Provider Business Practice Location Address Fax Number:
347-923-3217
Provider Enumeration Date:
12/17/2012

Additional Information

Authorized Official

Authorized Official Last Name:
KABIR
Authorized Official First Name:
IMRUL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-314-6763

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  018530 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 03427938 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: G400065872 . This is a "MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN):" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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