Provider Demographics
NPI:1538814793
Name:COMEBACK PT PC
Entity type:Organization
Organization Name:COMEBACK PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HASAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDALLA
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:718-380-8200
Mailing Address - Street 1:15319 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3943
Mailing Address - Country:US
Mailing Address - Phone:718-380-8200
Mailing Address - Fax:718-380-5381
Practice Address - Street 1:15319 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3943
Practice Address - Country:US
Practice Address - Phone:718-380-8200
Practice Address - Fax:718-380-5381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy