Healthcare Provider Details

I. General information

NPI: 1780437145
Provider Name (Legal Business Name): THE DREAMING TREE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2024
Last Update Date: 04/08/2024
Certification Date: 04/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14627 BEECH AVE
FLUSHING NY
11355-2172
US

IV. Provider business mailing address

4211 PARSONS BLVD APT 2A
FLUSHING NY
11355-2101
US

V. Phone/Fax

Practice location:
  • Phone: 667-276-1810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATHRINA MENDOZA
Title or Position: PHYSICAL THERAPIST
Credential:
Phone: 667-276-1810