=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962291112
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRIANA R. CAIAZZO, PHYSICAL THERAPY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/05/2025
-----------------------------------------------------
Last Update Date | 05/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2740 CROPSEY AVE APT 10E
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11214-6872
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-902-7520
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2740 CROPSEY AVE APT 10E
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11214-6872
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-902-7520
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | BRIANA CAIAZZO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 718-902-7520
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------