Provider Demographics
NPI:1699931535
Name:PIONEER REHAB PT PC
Entity type:Organization
Organization Name:PIONEER REHAB PT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAADI
Authorized Official - Middle Name:MOSTAFA
Authorized Official - Last Name:ELSAYED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-251-3303
Mailing Address - Street 1:2035 RALPH AVE
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5300
Mailing Address - Country:US
Mailing Address - Phone:718-251-3303
Mailing Address - Fax:718-251-3350
Practice Address - Street 1:2035 RALPH AVE
Practice Address - Street 2:SUITE 1-A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5300
Practice Address - Country:US
Practice Address - Phone:718-251-3303
Practice Address - Fax:718-251-3350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-30
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty