Healthcare Provider Details

I. General information

NPI: 1073843397
Provider Name (Legal Business Name): MINERVA SALOMON FRIAS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4499 MANHATTAN COLLEGE PKWY
BRONX NY
10471-3919
US

IV. Provider business mailing address

4499 MANHATTAN COLLEGE PKWY
BRONX NY
10471-3919
US

V. Phone/Fax

Practice location:
  • Phone: 718-548-5100
  • Fax:
Mailing address:
  • Phone: 718-548-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number027818
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: