Provider Demographics
NPI:1285947812
Name:DYNAMIC REHABILITATION PT PC
Entity type:Organization
Organization Name:DYNAMIC REHABILITATION PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FERIL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:917-519-6010
Mailing Address - Street 1:88 GREENWAY W
Mailing Address - Street 2:
Mailing Address - City:MANHASSET HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2225
Mailing Address - Country:US
Mailing Address - Phone:516-280-2923
Mailing Address - Fax:516-385-2574
Practice Address - Street 1:510 OCEAN AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-1208
Practice Address - Country:US
Practice Address - Phone:516-399-2225
Practice Address - Fax:516-385-2574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-24
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy