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General NPI Number Information
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NPI Number | 1174491971
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Entity Type | Organization
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Legal Business Name | PTA ON THE ROAD PLLC
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Dates
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Enumeration Date | 10/24/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 701 BUSHWICK AVE APT 1B
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City | BROOKLYN
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State | NY
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Zip | 11221-2553
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Country | US
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Telephone | 929-486-1330
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Fax |
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Provider Business Mailing Address
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Address Line | 701 BUSHWICK AVE APT 1B
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City | BROOKLYN
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State | NY
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Zip | 11221-2553
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Country | US
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Telephone | 929-486-1330
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANCIS DE LUCAS
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Credential | PTA
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Telephone | 929-486-1330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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