Provider Demographics
NPI:1982092904
Name:A2Z PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:A2Z PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MS PT
Authorized Official - Phone:347-922-4349
Mailing Address - Street 1:9229 QUEENS BLVD
Mailing Address - Street 2:SUITE 2C
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1056
Mailing Address - Country:US
Mailing Address - Phone:347-880-1884
Mailing Address - Fax:800-646-5901
Practice Address - Street 1:9229 QUEENS BLVD
Practice Address - Street 2:SUITE 2C
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1056
Practice Address - Country:US
Practice Address - Phone:347-880-1884
Practice Address - Fax:800-646-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021863225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02159479Medicaid