Healthcare Provider Details

I. General information

NPI: 1720907876
Provider Name (Legal Business Name): TICKLE TOES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 BEDFORD AVE
BROOKLYN NY
11205-3675
US

IV. Provider business mailing address

844 BEDFORD AVE
BROOKLYN NY
11205-3675
US

V. Phone/Fax

Practice location:
  • Phone: 347-907-2935
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ZISHA RUBIN
Title or Position: OWNER
Credential:
Phone: 347-907-2935