MEDICARE: W REHABILITATION ASSOCIATES PT & OT PLLC

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		NY
2	225X00000X	Occupational Therapist		NY

General Provider Information

NPI Number	:	1740714435
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W REHABILITATION ASSOCIATES PT & OT PLLC

Provider Business Mailing Address
First Line	:	165 DIVISION AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-7105
Country	:	US
Telephone Number	:	917-270-7917
Fax Number	:	629-298-0079

Provider Business Practice Location Address
First Line	:	165 DIVISION AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11211-7105
Country	:	US
Telephone Number	:	917-270-7917
Fax Number	:	629-298-0079

Authorized Official
Title or Position	:	OWNER
Name	:	ESTHER FRIED
Credential	:	OTR/L
Telephone Number	:	718-253-8000

Provider Enumeration Date	:	04/19/2017
Last Update Date	:	03/14/2018

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