Healthcare Provider Details

I. General information

NPI: 1295560258
Provider Name (Legal Business Name): DAVID PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2024
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14140 UNION TPKE
FLUSHING NY
11367-3696
US

IV. Provider business mailing address

148 GEORGE ST
BROOKLYN NY
11237-1912
US

V. Phone/Fax

Practice location:
  • Phone: 347-998-2240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ANDREA DAVID
Title or Position: OWNER
Credential:
Phone: 347-998-2240