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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