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General NPI Number Information
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NPI Number | 1962359224
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Entity Type | Organization
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Legal Business Name | FORM PHYSICAL THERAPY P.C.
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Dates
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Enumeration Date | 03/14/2026
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Last Update Date | 03/14/2026
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Provider Practice Location Address
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Address Line | 93 WORTH ST
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City | NEW YORK
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State | NY
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Zip | 10013-3412
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Country | US
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Telephone | 617-971-6422
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Fax |
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Provider Business Mailing Address
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Address Line | 432 E 89TH ST APT 1A
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City | NEW YORK
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State | NY
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Zip | 10128-6772
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRANDON ONG
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Credential | DPT
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Telephone | 617-971-6422
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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