Provider Demographics
NPI:1194296392
Name:G.M.B. PHYSICAL THERAPY
Entity type:Organization
Organization Name:G.M.B. PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYLOUNY
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:401-323-9561
Mailing Address - Street 1:415 E 80TH ST APT 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0634
Mailing Address - Country:US
Mailing Address - Phone:401-323-9561
Mailing Address - Fax:
Practice Address - Street 1:161 W 22ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2798
Practice Address - Country:US
Practice Address - Phone:914-222-3837
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy