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General NPI Number Information
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NPI Number | 1154829406
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Entity Type | Organization
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Legal Business Name | REFRESH PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 09/27/2023
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Provider Practice Location Address
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Address Line | 185 CLINTON AVE APT 4E
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City | BROOKLYN
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State | NY
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Zip | 11205-3508
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Country | US
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Telephone | 347-328-4103
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Fax |
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Provider Business Mailing Address
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Address Line | 185 CLINTON AVE APT 4E
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City | BROOKLYN
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State | NY
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Zip | 11205-3508
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Country | US
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Telephone | 347-328-4103
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DOMINIC FARNAN
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Credential | P.T.
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Telephone | 347-328-4103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 036975
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License Number State | NY
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