Provider Demographics
NPI:1083977409
Name:I CARE PHYSICAL THERAPY AND ACUPUNCTURE PLLC
Entity type:Organization
Organization Name:I CARE PHYSICAL THERAPY AND ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GAZDZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, ECS, OCS
Authorized Official - Phone:516-847-4277
Mailing Address - Street 1:107 E BROADWAY
Mailing Address - Street 2:FL 3
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-7006
Mailing Address - Country:US
Mailing Address - Phone:212-233-0889
Mailing Address - Fax:212-233-0898
Practice Address - Street 1:107 E BROADWAY
Practice Address - Street 2:FL 3
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7006
Practice Address - Country:US
Practice Address - Phone:212-233-0889
Practice Address - Fax:212-233-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2017-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171100000X, 2251X0800X
NY021837225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04109468Medicaid
NY04109468Medicaid