| Physician Last Name: | Queens Medical Rehabilitation |
| Physician First Name: | P.C. |
| Physician Middle Name: | |
| Address: | Queens Medical Rehabilitation, P.C.
69-30 Austin Street
Forest Hills, New York 11375 |
| License Number: | 192310 |
| License Type: | |
| Year of Birth: |
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| Effective Date: | 11/06/2003 |
| Action Description for DOH Webpage: | Annulment of certificate of incorporation pursuant to Section 230-a of the New York State Public Health Law and Section 1503(d) of the New York State Business Corporation Law |
| Misconduct Description for DOH Webpage: | The corporation admitted guilt to the charge of willfully failing to comply with Section 1503 of the Business Corporation Law in violation of New York State Education Law Section 6530(12). |
| License Limitations or Conditions for DOH Webpage: | |
| Board Order: |
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