Healthcare Provider Details

I. General information

NPI: 1003961491
Provider Name (Legal Business Name): INFINITY SPORTS MEDICINE AND REHABILITATION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 10/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W 19TH ST
NEW YORK NY
10011-4223
US

IV. Provider business mailing address

55 W 19TH ST
NEW YORK NY
10011-4223
US

V. Phone/Fax

Practice location:
  • Phone: 212-488-3400
  • Fax: 212-488-3401
Mailing address:
  • Phone: 212-488-3400
  • Fax: 212-488-3401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number225751
License Number StateNY

VIII. Authorized Official

Name: DR. MARINA BABIY
Title or Position: MEMBER
Credential: M.D
Phone: 212-488-3400