Healthcare Provider Details

I. General information

NPI: 1982202404
Provider Name (Legal Business Name): MOBILITY HEALTH PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10545 AVENUE M
BROOKLYN NY
11236-4603
US

IV. Provider business mailing address

10545 AVENUE M
BROOKLYN NY
11236-4603
US

V. Phone/Fax

Practice location:
  • Phone: 718-496-0110
  • Fax:
Mailing address:
  • Phone: 718-496-0110
  • 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. GINA WILLIAMS
Title or Position: PHYSICAL THERAPIST/OWNER
Credential: DOCTOR OF PT
Phone: 718-496-0110