Provider Demographics
NPI:1063623239
Name:UNIQUE REHAB PT P.C.
Entity type:Organization
Organization Name:UNIQUE REHAB PT P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ISLAM
Authorized Official - Middle Name:SHAFIK
Authorized Official - Last Name:ABDELATY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-806-3958
Mailing Address - Street 1:6976 JUNIPER BLVD S
Mailing Address - Street 2:2ND FLR
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-1732
Mailing Address - Country:US
Mailing Address - Phone:917-806-3958
Mailing Address - Fax:718-205-7004
Practice Address - Street 1:6976 JUNIPER BLVD S
Practice Address - Street 2:2ND FLR
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-1732
Practice Address - Country:US
Practice Address - Phone:917-806-3958
Practice Address - Fax:718-205-7004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027020-1320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities