Provider Demographics
NPI:1861540395
Name:RT PHYSICAL THERAPY AND REHABILITATION, PLLC
Entity type:Organization
Organization Name:RT PHYSICAL THERAPY AND REHABILITATION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REUVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:718-393-3844
Mailing Address - Street 1:6254 97TH PL
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1346
Mailing Address - Country:US
Mailing Address - Phone:718-393-3477
Mailing Address - Fax:
Practice Address - Street 1:6254 97TH PL
Practice Address - Street 2:SUITE 1A
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1346
Practice Address - Country:US
Practice Address - Phone:718-393-3477
Practice Address - Fax:718-393-3479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015861-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID
NYQ4W4J1Medicare PIN
NY06805Medicare PIN