NEW FORM PHYSICAL THERAPY P.C.
NPI 1053078170
Physical Therapist - Electrophysiology, Clinical in Brooklyn, NY

Active since November 23, 2021
1711 RALPH AVE, BROOKLYN, NY 11236(718) 649-6356 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 15, 2025, Nov 23, 2021 (2 updates tracked since 2021).

About New Form Physical Therapy P.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NEW FORM PHYSICAL THERAPY P.C. (NPI 1053078170) is a healthcare organization registered as an electrophysiology, clinical in Brooklyn, New York and active in the NPI registry since November 2021. The organization lists Rinku Kuril, Owner, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053078170
Entity TypeOrganization
Primary Taxonomy2251E1300X
Legal Business NameNEW FORM PHYSICAL THERAPY P.C.
Location Address1711 RALPH AVEBrooklyn, NY 11236-3319
Mailing Address14004 Rockingham RdGermantown, MD 20874-2250
Organization SubpartNo
Authorized OfficialRinku KurilOwner, Ceo · (917) 282-0238
Enumeration DateNovember 23, 2021
Last NPPES UpdateMay 15, 20252 updates tracked since enumeration
NPPES CertifiedMay 15, 2025
NPI 1053078170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysical Therapist · Electrophysiology, ClinicalRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251E1300X
Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Clinical Electrophysiologic Physical Therapy, who has demonstrated specialized knowledge and skill in electrophysiologic examinations and evaluations and encompasses both the professional and technical components of the observation, recording, analysis, and interpretation of bioelectric muscle and nerve potentials, detected by means of surface or needle electrodes, for the purpose of evaluating the integrity of the neuromuscular system. Electrophysiologic evaluations include, but are not limited to, electrodiagnostic testing, which includes clinical needle electromyography, motor and sensory nerve conduction studies, and other evoked potential procedures.

1711 RALPH AVE, Brooklyn, NY 11236

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Internal Medicine
1711 RALPH AVE
BROOKLYN, NY 11236
Physician Assistant (Medical)
1711 RALPH AVE
BROOKLYN, NY 11236
Allergy & Immunology
1711 RALPH AVE
BROOKLYN, NY 11236
Internal Medicine
1711 RALPH AVE
BROOKLYN, NY 11236
Family Medicine
1711 RALPH AVE
BROOKLYN, NY 11236
Internal Medicine
1711 RALPH AVE
BROOKLYN, NY 11236
In Home Supportive Care
1711 RALPH AVE
BROOKLYN, NY 11236

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is New Form Physical Therapy P.C.'s NPI number?

The NPI number for New Form Physical Therapy P.C. is 1053078170. It was assigned to this organization in the NPPES registry on November 23, 2021.

Where is New Form Physical Therapy P.C. located?

New Form Physical Therapy P.C. is located at 1711 Ralph Ave, Brooklyn, NY 11236. The listed phone number is (718) 649-6356.

What is New Form Physical Therapy P.C.'s specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Electrophysiology, Clinical, with taxonomy code 2251E1300X.

When was this NPI record last updated?

The NPPES record for New Form Physical Therapy P.C. was last updated on May 15, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.