Healthcare Provider Details

I. General information

NPI: 1760718001
Provider Name (Legal Business Name): FLEXITOUCH PT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 NEPTUNE AVE
BROOKLYN NY
11235-6845
US

IV. Provider business mailing address

308 NEPTUNE AVE
BROOKLYN NY
11235-6845
US

V. Phone/Fax

Practice location:
  • Phone: 718-615-0800
  • Fax: 718-934-4474
Mailing address:
  • Phone: 718-615-0800
  • Fax: 718-934-4474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number024082-1
License Number StateNY

VIII. Authorized Official

Name: DR. IRENE MARIANO
Title or Position: OWNER
Credential: PT
Phone: 718-615-0800