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Organization
IMPERIAL REHAB PT PC
Active
Organization
IMPERIAL REHAB PT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALED AAGA PT (PRESIDENT)
(631) 805-8655
Entity
Organization
Contact information
Practice address
21808 HEMPSTEAD AVE, 2 FL, QUEENS VILLAGE, NY 11429-1235
(631) 805-8655
(718) 998-9059
Mailing address
30 BAY 17TH ST, BROOKLYN, NY 11214-3706
(631) 805-8655
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
032839
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032839
LICENSE
NY
Enumeration date
02/05/2014
Last updated
02/05/2014
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