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General NPI Number Information
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NPI Number | 1326397159
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Entity Type | Organization
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Legal Business Name | BASE PHYSICAL THERAPY, PLLC
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Dates
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Enumeration Date | 09/07/2012
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 47 W 14TH ST 5TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 703-772-0586
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Fax | 917-463-0897
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Provider Business Mailing Address
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Address Line | 376 GRAHAM AVE. 2R
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City | BROOKLYN
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State | NY
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Zip | 11211
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Country | US
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Telephone | 703-772-0586
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Fax | 917-463-0897
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Authorized Official
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Title or Position | DOCTOR OF PHYSICAL THERAPY
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Name | DR. NINA A FIGUEROA
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Credential | PT,DPT
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Telephone | 703-772-0586
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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 | 62-030781
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License Number State | NY
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