MEDICARE: SARA GROSSMAN 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
1	225100000X	Physical Therapist	030487-1	NY

General Provider Information

NPI Number	:	1619114196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA GROSSMAN PT

Provider Business Mailing Address
First Line	:	2555 OCEAN AVE
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4552
Country	:	US
Telephone Number	:	718-732-3869
Fax Number	:	347-374-6860

Provider Business Practice Location Address
First Line	:	2555 OCEAN AVE
Second Line	:	2ND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4552
Country	:	US
Telephone Number	:	718-732-3869
Fax Number	:	347-374-6860

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

Provider Enumeration Date	:	01/21/2009
Last Update Date	:	01/21/2009

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Directions to “ SARA GROSSMAN PT” Practice Location

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