Provider Demographics
NPI:1053578187
Name:RAKOWSKI, GREGORY PAUL (PT)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:PAUL
Last Name:RAKOWSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:104 YONKERS AVE
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-3911
Mailing Address - Country:US
Mailing Address - Phone:914-282-2559
Mailing Address - Fax:480-287-8653
Practice Address - Street 1:22 W 21ST ST
Practice Address - Street 2:#400 - SPORTS MED AT CHELSEA
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6904
Practice Address - Country:US
Practice Address - Phone:914-282-2559
Practice Address - Fax:480-287-8653
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0141941225100000X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic