MEDICARE: ARTHUR DAVID GREENBAUM P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	4871	NY

General Provider Information

NPI Number	:	1386684660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR DAVID GREENBAUM P.T.

Provider Business Mailing Address
First Line	:	PO BOX 1232
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-0918
Country	:	US
Telephone Number	:	516-220-3409
Fax Number	:	516-740-5815

Provider Business Practice Location Address
First Line	:	16302 NORTHERN BLVD
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11358-2645
Country	:	US
Telephone Number	:	718-353-2225
Fax Number	:	718-353-3227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	06/21/2011

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