Healthcare Provider Details

I. General information

NPI: 1811912314
Provider Name (Legal Business Name): GREG BABIEC PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

159 E 74TH ST FIRST FLOOR
NEW YORK NY
10021-3235
US

IV. Provider business mailing address

159 E 74TH ST FIRST FLOOR
NEW YORK NY
10021-3235
US

V. Phone/Fax

Practice location:
  • Phone: 212-439-1596
  • Fax: 212-439-1608
Mailing address:
  • Phone: 212-439-1596
  • Fax: 212-439-1608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0220931
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: