Provider Demographics
NPI:1023340098
Name:REHAB ONE PHYSICAL THERAPY P C
Entity type:Organization
Organization Name:REHAB ONE PHYSICAL THERAPY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:IGOR
Authorized Official - Middle Name:
Authorized Official - Last Name:OLEVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:718-533-8588
Mailing Address - Street 1:8635 QUEENS BLVD
Mailing Address - Street 2:1B
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4434
Mailing Address - Country:US
Mailing Address - Phone:718-533-8588
Mailing Address - Fax:718-533-1249
Practice Address - Street 1:8635 QUEENS BLVD
Practice Address - Street 2:1B
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4434
Practice Address - Country:US
Practice Address - Phone:718-533-8588
Practice Address - Fax:718-533-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty