MEDICARE: MS. BRIANNA BACHELLE ARJONA DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician	PT872138	DC
2	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	40QA02013300	NJ

General Provider Information

NPI Number	:	1033637541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BRIANNA BACHELLE ARJONA DPT

Provider Business Mailing Address
First Line	:	75 MAIDEN LN RM 404
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-4636
Country	:	US
Telephone Number	:	917-455-4881
Fax Number	:

Provider Business Practice Location Address
First Line	:	75 MAIDEN LN RM 404
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10038-4636
Country	:	US
Telephone Number	:	917-455-4881
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2017
Last Update Date	:	10/25/2023

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