MEDICARE: RONA J BIRNBAUM

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	010120-01	NY

General Provider Information

NPI Number	:	1588507040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONA J BIRNBAUM

Provider Business Mailing Address
First Line	:	2715 LINCOLN BLVD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4772
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2715 LINCOLN BLVD
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4772
Country	:	US
Telephone Number	:	516-695-8382
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ RONA J BIRNBAUM ” Practice Location

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