Healthcare Provider Details

I. General information

NPI: 1124838354
Provider Name (Legal Business Name): CAUGHLAN PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 FLATBUSH AVE STE K
BROOKLYN NY
11225-3706
US

IV. Provider business mailing address

101 WOODRUFF AVE APT 1C
BROOKLYN NY
11226-1213
US

V. Phone/Fax

Practice location:
  • Phone: 929-463-9795
  • Fax:
Mailing address:
  • Phone: 314-604-3449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MOLLY K CAUGHLAN
Title or Position: FOUNDER, PHYSICAL THERAPIST
Credential: PT, DPT
Phone: 314-604-3449