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General NPI Number Information
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NPI Number | 1194497958
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Entity Type | Individual
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Provider Name | SAMUEL BECOURTNEY
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Gender | Male
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 251 5TH AVE FL 7
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City | NEW YORK
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State | NY
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Zip | 10016-6515
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Country | US
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Telephone | 646-693-3517
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Fax | 646-880-9014
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Provider Business Mailing Address
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Address Line | 400 E 89TH ST APT 7P
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City | NEW YORK
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State | NY
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Zip | 10128-6734
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Country | US
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Telephone | 646-693-3517
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Fax | 646-880-9014
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 045370
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License Number State | NY
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