Organization
ACTIVE HEALING PHYSICAL THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMRUL KABIR DPT (PRESIDENT/ PHYSICAL THERAPY)
(718) 314-6763
Entity
Organization
Contact information
Practice address
16902 HIGHLAND AVE BSMT, JAMAICA, NY 11432-2632
(718) 844-4832
(347) 923-3217
Mailing address
8450 169TH ST, APT 415, JAMAICA, NY 11432-2049
(718) 314-6763
(347) 923-3217
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
018530
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03435572
—
NY
Enumeration date
11/02/2011
Last updated
04/04/2022
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