| Organization Name: | GENESIS PHYSICAL THERAPY PC |
| NPI Number: | 1386896397 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MICHAEL ABORISADE (PRESIDENT/CEO) |
| Mailing Address: | 14622 222nd St Springfield Gardens |
| State: | NY US |
| Postal Code: | 114133835 |
| Phone Number: | 7184153947 |
| Fax Number: | 7189494243 |
| NPI Enumeration Date: | 10/21/2008 |
| NPI Last Update Date: | 10/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 320700000X |
| License Number: | O22008 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Residential Treatment Facility, Physical Disabilities |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |