Healthcare Provider Details

I. General information

NPI: 1083983092
Provider Name (Legal Business Name): BRILL PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2011
Last Update Date: 01/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MADISON AVE LEVEL 1B
NEW YORK NY
10010-3643
US

IV. Provider business mailing address

11 MADISON AVE # LEVEL1B
NEW YORK NY
10010-3643
US

V. Phone/Fax

Practice location:
  • Phone: 212-325-0961
  • Fax:
Mailing address:
  • Phone: 212-325-0961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251H1200X
TaxonomyHand Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MARGARET W BRILL
Title or Position: OWNER
Credential: P.T. O.C.S
Phone: 212-325-0961