Provider Demographics
NPI:1386925873
Name:RESILIENT CARE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:RESILIENT CARE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORCILLA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-426-7900
Mailing Address - Street 1:5718 WOODSIDE AVE
Mailing Address - Street 2:SUITE B102
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3415
Mailing Address - Country:US
Mailing Address - Phone:718-426-7900
Mailing Address - Fax:718-426-7500
Practice Address - Street 1:5718 WOODSIDE AVE
Practice Address - Street 2:SUITE B102
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-3415
Practice Address - Country:US
Practice Address - Phone:718-426-7900
Practice Address - Fax:718-426-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization