Healthcare Provider Details

I. General information

NPI: 1265340087
Provider Name (Legal Business Name): GARRETT BIEBER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 FRONT ST
MILLBROOK NY
12545-5948
US

IV. Provider business mailing address

468 PARK AVE
BINGHAMTON NY
13903-6003
US

V. Phone/Fax

Practice location:
  • Phone: 845-677-5021
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number014087
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: