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NPI Code Detail

MEDICARE: BACK TO HEALTH PHYSICAL THERAPY ASSOCIATES P.C.

MEDICARE: BACK TO HEALTH PHYSICAL THERAPY ASSOCIATES P.C.
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
1225100000XPhysical Therapist020104NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558311001
Entity Type Code : Organization
Provider Name (Legal Business Name) : BACK TO HEALTH PHYSICAL THERAPY ASSOCIATES P.C.
Provider Business Mailing Address
First Line : 2445 E 71ST ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-6513
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1414 NEWKIRK AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11226-6522
Country : US
Telephone Number : 718-743-0090
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : YAKOV OSTROVSKY
Credential :
Telephone Number : 718-743-0090
Provider Enumeration Date : 05/12/2006
Last Update Date : 08/18/2010

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