Healthcare Provider Details

I. General information

NPI: 1346263076
Provider Name (Legal Business Name): OFIR ISAAC PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 AVENUE P
BROOKLYN NY
11229-7064
US

IV. Provider business mailing address

PO BOX 297064
BROOKLYN NY
11229-7064
US

V. Phone/Fax

Practice location:
  • Phone: 718-339-6885
  • Fax: 718-339-0945
Mailing address:
  • Phone: 718-339-6885
  • Fax: 718-339-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number017846-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: