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Organization
PREMIER EAST PHYSICAL MEDICINE AND REHABILITATION, PC
Active
Organization
PREMIER EAST PHYSICAL MEDICINE AND REHABILITATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJ TOLAT MD (OWNER)
(631) 698-3500
Entity
Organization
Contact information
Practice address
2920 ROUTE 112, MEDFORD, NY 11763-1451
(631) 698-3500
(631) 698-3600
Mailing address
PO BOX 9308, GARDEN CITY, NY 11530-9308
(516) 294-4590
(516) 294-5185
Taxonomy
Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
207587
NY
Other
Enumeration date
06/28/2011
Last updated
04/07/2020
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