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General NPI Number Information
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NPI Number | 1558216648
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Entity Type | Organization
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Legal Business Name | QUEENS BROOKLYN PHYSICAL THERAPY
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Dates
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Enumeration Date | 03/03/2026
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Last Update Date | 03/03/2026
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Provider Practice Location Address
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Address Line | 6093 MYRTLE AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5926
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Country | US
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Telephone | 718-490-9909
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Fax | 347-223-4405
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Provider Business Mailing Address
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Address Line | 6093 MYRTLE AVE
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City | RIDGEWOOD
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State | NY
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Zip | 11385-5926
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Country | US
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Telephone | 718-490-9909
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Fax | 347-223-4405
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Authorized Official
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Title or Position | OWNER
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Name | OLIVER TELLO
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Credential | PT
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Telephone | 917-295-1025
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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 |
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License Number State |
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