MEDICARE: DR. VIBHOR MAKKAR D.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	031401-1	NY

General Provider Information

NPI Number	:	1649508680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIBHOR MAKKAR D.P.T

Provider Business Mailing Address
First Line	:	17 TALON WAY
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-6238
Country	:	US
Telephone Number	:	516-592-0297
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 TALON WAY
Second Line	:
City	:	DIX HILLS
State	:	NY
Zip	:	11746-6238
Country	:	US
Telephone Number	:	516-592-0297
Fax Number	:

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

Provider Enumeration Date	:	12/03/2009
Last Update Date	:	07/21/2014

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