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General NPI Number Information
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NPI Number | 1609431576
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Entity Type | Organization
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Legal Business Name | MAIMONIDES BONE AND JOINT FACULTY PRACTICE PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 05/07/2019
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Provider Practice Location Address
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Address Line | 6010 BAY PKWY FL 1
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City | BROOKLYN
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State | NY
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Zip | 11204-6079
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Country | US
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Telephone | 718-283-8962
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Fax | 718-635-8962
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Provider Business Mailing Address
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Address Line | 6010 BAY PKWY FL 1
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City | BROOKLYN
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State | NY
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Zip | 11204-6079
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Country | US
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Telephone | 718-283-8962
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Fax | 718-635-8962
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Authorized Official
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Title or Position | ADMINSITARTIVE DIRECTOR
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Name | MR. RENE BARRO
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Credential | PT, MS, MBA
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Telephone | 718-283-6087
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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