Provider Demographics
NPI:1063660769
Name:WELLNESS PHYSICAL THERAPY & REHABILITATION SERVICES PLLC
Entity type:Organization
Organization Name:WELLNESS PHYSICAL THERAPY & REHABILITATION SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AKL
Authorized Official - Suffix:
Authorized Official - Credentials:PLLC
Authorized Official - Phone:718-382-8881
Mailing Address - Street 1:215 AVENUE T
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3753
Mailing Address - Country:US
Mailing Address - Phone:718-382-8881
Mailing Address - Fax:718-382-8880
Practice Address - Street 1:215 AVENUE T
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-3753
Practice Address - Country:US
Practice Address - Phone:718-382-8881
Practice Address - Fax:718-382-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027913225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty