Healthcare Provider Details

I. General information

NPI: 1437654761
Provider Name (Legal Business Name): GROW & GO PT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 03/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1867 HARING ST FL 1
BROOKLYN NY
11229-3209
US

IV. Provider business mailing address

1867 HARING ST FL 1
BROOKLYN NY
11229-3209
US

V. Phone/Fax

Practice location:
  • Phone: 347-644-7667
  • Fax:
Mailing address:
  • Phone: 347-644-7667
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number035774
License Number StateNY

VIII. Authorized Official

Name: DR. DONNA KLEYMAN
Title or Position: PRESIDENT, PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 917-968-5802