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NPI Code Detail

MEDICARE: MARCUS DUBOUZET PT

MEDICARE: MARCUS DUBOUZET PT
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 Therapist045125NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1045125OTHERNYREGISTRATION

General Provider Information

NPI Number : 1588238422
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS DUBOUZET PT
Provider Business Mailing Address
First Line : 1270 44TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2260
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1270 44TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-2260
Country : US
Telephone Number : 718-840-3399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2021
Last Update Date : 05/15/2021

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Directions to “ MARCUS DUBOUZET PT” Practice Location

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