Provider Demographics
NPI:1063595577
Name:CHEQUE PHYSICAL THERAPY P C
Entity type:Organization
Organization Name:CHEQUE PHYSICAL THERAPY P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGEL
Authorized Official - Last Name:CHEQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-872-3944
Mailing Address - Street 1:162 ANN ST
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-2704
Mailing Address - Country:US
Mailing Address - Phone:516-872-3944
Mailing Address - Fax:516-872-3944
Practice Address - Street 1:345 E 94TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5684
Practice Address - Country:US
Practice Address - Phone:212-534-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ18C61Medicare ID - Type UnspecifiedIINDIVIDUAL PRACTITIONER