Healthcare Provider Details

I. General information

NPI: 1497704225
Provider Name (Legal Business Name): BENJAMIN GELFAND PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 05/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 56TH ST
NEW YORK NY
10022
US

IV. Provider business mailing address

576 BROADHOLLOW RD
MELVILLE NY
11747-5002
US

V. Phone/Fax

Practice location:
  • Phone: 212-355-7287
  • Fax:
Mailing address:
  • Phone: 631-359-5859
  • Fax: 631-396-0865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number010481
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: