Provider Demographics
NPI:1063784866
Name:JONA CARE PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:JONA CARE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HANY
Authorized Official - Middle Name:MEKHAEL
Authorized Official - Last Name:MEKHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:917-776-6079
Mailing Address - Street 1:107 ORMSBY AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-4040
Mailing Address - Country:US
Mailing Address - Phone:917-776-6079
Mailing Address - Fax:718-698-1016
Practice Address - Street 1:107 ORMSBY AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-4040
Practice Address - Country:US
Practice Address - Phone:917-776-6079
Practice Address - Fax:718-698-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty