Healthcare Provider Details

I. General information

NPI: 1225928252
Provider Name (Legal Business Name): NEURORENEW PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 ORTEGA ST
SAN FRANCISCO CA
94122-4623
US

IV. Provider business mailing address

501 ORTEGA ST
SAN FRANCISCO CA
94122-4623
US

V. Phone/Fax

Practice location:
  • Phone: 508-504-6045
  • Fax: 415-712-0027
Mailing address:
  • Phone: 408-504-6045
  • Fax: 415-712-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH POPOLIZIO
Title or Position: OWNER
Credential: PT, DPT, NCS
Phone: 408-504-6045