Provider Demographics
NPI:1518856897
Name:RIDGE REHAB PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:RIDGE REHAB PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDURRAHMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUSHADY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:347-210-7348
Mailing Address - Street 1:271 86TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-4929
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1647 MACOMBS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-7659
Practice Address - Country:US
Practice Address - Phone:347-210-7348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy