Provider Demographics
NPI:1538780507
Name:HDT TENDER LOVING CARE PHYSICAL THERAPY, P.C.
Entity type:Organization
Organization Name:HDT TENDER LOVING CARE PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HENLER
Authorized Official - Middle Name:
Authorized Official - Last Name:DATU TAHIL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:917-355-7522
Mailing Address - Street 1:1912 LENOX AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-4053
Mailing Address - Country:US
Mailing Address - Phone:917-355-7522
Mailing Address - Fax:
Practice Address - Street 1:4055 COLLEGE POINT BLVD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5169
Practice Address - Country:US
Practice Address - Phone:917-355-7522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-30
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty