Healthcare Provider Details

I. General information

NPI: 1124458385
Provider Name (Legal Business Name): ARYEH LEIB DICKER D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 GOLF DR
VALLEY STREAM NY
11581-3520
US

IV. Provider business mailing address

779 GOLF DR
VALLEY STREAM NY
11581-3520
US

V. Phone/Fax

Practice location:
  • Phone: 917-363-4720
  • Fax:
Mailing address:
  • Phone: 917-363-4720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number037001
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: