Provider Demographics
NPI:1528656410
Name:KRB REHAB PT PLLC
Entity type:Organization
Organization Name:KRB REHAB PT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:BYNES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:407-448-0207
Mailing Address - Street 1:717 STERLING PL APT 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-3838
Mailing Address - Country:US
Mailing Address - Phone:407-448-0207
Mailing Address - Fax:
Practice Address - Street 1:717 STERLING PL APT 6
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-3838
Practice Address - Country:US
Practice Address - Phone:407-448-0207
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy