Provider Demographics
NPI:1134290828
Name:HEALING QUEST PHYSICAL THERAPY, PC
Entity type:Organization
Organization Name:HEALING QUEST PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LAURIE
Authorized Official - Last Name:LAUFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-982-6496
Mailing Address - Street 1:1911 RICHMOND AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1911 RICHMOND AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3913
Practice Address - Country:US
Practice Address - Phone:718-982-6496
Practice Address - Fax:718-982-6751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy