Organization
CLASSICAL REHABILITATION PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VLADISLAV RAVITSKI PT (PHYSICAL THERAPIST)
(929) 423-7305
Entity
Organization
Contact information
Practice address
501 BRIGHTON BEACH AVE FL 2, BROOKLYN, NY 11235-6403
(929) 423-7305
Mailing address
415 RARITAN AVE, STATEN ISLAND, NY 10305-2345
(718) 667-6111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922160480
NPI INDIVIDUAL
NY
Enumeration date
01/16/2019
Last updated
01/23/2019
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