Organization
COMMUNITY CARE PHYSICAL THERAPY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRENDER JAIN (MANAGER)
(917) 715-7671
Entity
Organization
Contact information
Practice address
8510 122ND ST, KEW GARDENS, NY 11415-3232
(718) 501-0421
Mailing address
8510 122ND ST, KEW GARDENS, NY 11415-3232
(718) 501-0421
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
031350-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031350-1
LICENSE#
NY
Enumeration date
06/10/2013
Last updated
06/10/2013
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