MEDICARE: DYNAMIC SOLUTIONS PEDIATRIC PHYSICAL & OCCUPATIONAL THERAPY

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	225XP0200X	Pediatric Occupational Therapist	006091	NY
2	2251P0200X	Pediatric Physical Therapist	016157-1	NY

General Provider Information

NPI Number	:	1750525598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DYNAMIC SOLUTIONS PEDIATRIC PHYSICAL & OCCUPATIONAL THERAPY

Provider Business Mailing Address
First Line	:	532 COURT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-3986
Country	:	US
Telephone Number	:	718-254-0800
Fax Number	:

Provider Business Practice Location Address
First Line	:	532 COURT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-3986
Country	:	US
Telephone Number	:	718-254-0800
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. MIRAV MIRIAM NEWMAN
Credential	:	P.T.
Telephone Number	:	718-254-0800

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	04/23/2009

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Directions to “DYNAMIC SOLUTIONS PEDIATRIC PHYSICAL & OCCUPATIONAL THERAPY ” Practice Location

Language	Start Address	Practice Location

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