Healthcare Provider Details

I. General information

NPI: 1558500066
Provider Name (Legal Business Name): ARIEL ZYLBERBERG PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2009
Last Update Date: 02/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 MARTIN RD
FRANKLIN SQUARE NY
11010-1819
US

IV. Provider business mailing address

614 MARTIN RD
FRANKLIN SQUARE NY
11010-1819
US

V. Phone/Fax

Practice location:
  • Phone: 516-385-5090
  • Fax:
Mailing address:
  • Phone: 516-385-5090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number0248321
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: