Provider Demographics
NPI:1972780963
Name:BORO PARK REHABILITATION P.T., PLLC
Entity type:Organization
Organization Name:BORO PARK REHABILITATION P.T., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KLEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-854-0447
Mailing Address - Street 1:619 ELVIRA AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5404
Mailing Address - Country:US
Mailing Address - Phone:917-468-5253
Mailing Address - Fax:800-275-3671
Practice Address - Street 1:619 ELVIRA AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5404
Practice Address - Country:US
Practice Address - Phone:917-468-5253
Practice Address - Fax:800-275-3671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty