Healthcare Provider Details

I. General information

NPI: 1053133777
Provider Name (Legal Business Name): TREVOR DUNCAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2024
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 BROADWAY FL 12-200
NEW YORK NY
10004-1617
US

IV. Provider business mailing address

3 DOLLARD DR
NORTH BABYLON NY
11703-1505
US

V. Phone/Fax

Practice location:
  • Phone: 347-730-8334
  • Fax:
Mailing address:
  • Phone: 347-730-8334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number056358
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: