Provider Demographics
NPI:1841450814
Name:ROCKLAND RECOVERY PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:ROCKLAND RECOVERY PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:SERRANO
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:917-703-3021
Mailing Address - Street 1:873 ROUTE 45
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NEW HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:10977
Mailing Address - Country:US
Mailing Address - Phone:845-354-7779
Mailing Address - Fax:
Practice Address - Street 1:873 ROUTE 45
Practice Address - Street 2:SUITE 102
Practice Address - City:NEW HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:10977
Practice Address - Country:US
Practice Address - Phone:845-354-7779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-13
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0273061225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty