Healthcare Provider Details

I. General information

NPI: 1245153345
Provider Name (Legal Business Name): JOHN RHEY TAKAISAN WEBER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 WILLIAMSBRIDGE RD
BRONX NY
10461-1602
US

IV. Provider business mailing address

229 E 21ST ST
NEW YORK NY
10010-6433
US

V. Phone/Fax

Practice location:
  • Phone: 718-823-3900
  • Fax:
Mailing address:
  • Phone: 929-690-7079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number050924
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: