Provider Demographics
NPI:1528847027
Name:PIVOTAL CARE PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:PIVOTAL CARE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:USMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:646-474-3500
Mailing Address - Street 1:2064 CENTRAL DR N
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5114
Mailing Address - Country:US
Mailing Address - Phone:646-474-3500
Mailing Address - Fax:
Practice Address - Street 1:18818 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11412-4028
Practice Address - Country:US
Practice Address - Phone:646-474-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty