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Organization
PHYSICAL THERAPY ASSOCIATES OF GREAT NECK PC
Active
Organization
PHYSICAL THERAPY ASSOCIATES OF GREAT NECK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD P GRUCELA MS PT (PRESIDENT)
(516) 829-8450
Entity
Organization
Contact information
Practice address
800 NORTHERN BLVD, GREAT NECK, NY 11021-5314
(516) 829-8450
(516) 829-8452
Mailing address
800 NORTHERN BLVD, GREAT NECK, NY 11021-5314
(516) 829-8450
(516) 829-8452
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30601
CIGNA HMO
—
01
—
5C7180
HEALTHNET
NY
01
—
A976084
OXFORD
—
Enumeration date
09/23/2005
Last updated
08/15/2011
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