Healthcare Provider Details

I. General information

NPI: 1740508910
Provider Name (Legal Business Name): PRIME MOVERS PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2010
Last Update Date: 10/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2752 OCEAN AVENUE
BROOKLYN NY
11229
US

IV. Provider business mailing address

469 FASHION AVENUE SUITE 327-328
NEW YORK NY
10018
US

V. Phone/Fax

Practice location:
  • Phone: 718-769-9001
  • Fax: 718-796-9002
Mailing address:
  • Phone: 212-359-9592
  • Fax: 718-775-3419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number022691
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number022691
License Number StateNY

VIII. Authorized Official

Name: DR. MICHAEL M MORGANN
Title or Position: PRESIDENT/PT
Credential: DPT
Phone: 212-359-9593