Provider Demographics
NPI:1285938589
Name:REHAB SPECIALISTS PT, P.C
Entity type:Organization
Organization Name:REHAB SPECIALISTS PT, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREDIDENT/SOLE OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BASILIO
Authorized Official - Middle Name:ESPINO
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:914-426-7423
Mailing Address - Street 1:21 RYDER PL STE 1000
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-1200
Mailing Address - Country:US
Mailing Address - Phone:718-880-1240
Mailing Address - Fax:888-773-1644
Practice Address - Street 1:21 RYDER PL STE 1000
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1200
Practice Address - Country:US
Practice Address - Phone:914-426-7423
Practice Address - Fax:888-773-1644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-29
Last Update Date:2024-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027734261QP2000X, 261QP2000X
NY022940261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty