MEDICARE: DR. CHANA FROMMER PT, DPT, OCS, SCS

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	2251S0007X	Sports Physical Therapist	021922	NY
2	2251X0800X	Orthopedic Physical Therapist	021922	NY

General Provider Information

NPI Number	:	1851348072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHANA FROMMER PT, DPT, OCS, SCS

Provider Business Mailing Address
First Line	:	100 COLLEGE RD
Second Line	:
City	:	MONSEY
State	:	NY
Zip	:	10952-2017
Country	:	US
Telephone Number	:	845-352-0085
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 E 40TH ST
Second Line	:	SUITE 807
City	:	NEW YORK
State	:	NY
Zip	:	10016-1801
Country	:	US
Telephone Number	:	212-584-2610
Fax Number	:	212-584-2612

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/09/2012

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