Healthcare Provider Details

I. General information

NPI: 1336081181
Provider Name (Legal Business Name): BRIDGE PT, OT & SPEECH SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2026
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16316 84TH ST
HOWARD BEACH NY
11414-3319
US

IV. Provider business mailing address

16316 84TH ST
HOWARD BEACH NY
11414-3319
US

V. Phone/Fax

Practice location:
  • Phone: 718-541-3575
  • Fax:
Mailing address:
  • Phone: 718-541-3575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTINE CLIFFORD
Title or Position: CEO
Credential: DPT
Phone: 718-541-3575