Provider Demographics
NPI:1053921197
Name:PARADIGM MEDICAL REHABILITATION PLLC
Entity type:Organization
Organization Name:PARADIGM MEDICAL REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KUNAL
Authorized Official - Middle Name:DEVDATT
Authorized Official - Last Name:OAK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-307-9892
Mailing Address - Street 1:334 HILLSIDE DR S
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2720
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:888 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4914
Practice Address - Country:US
Practice Address - Phone:516-719-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty