MEDICARE: PHYSICAL THERAPY UNLIMITED, PLLC

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1053467837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY UNLIMITED, PLLC

Provider Business Mailing Address
First Line	:	2919 AVENUE T
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4063
Country	:	US
Telephone Number	:	718-336-4390
Fax Number	:	718-336-4395

Provider Business Practice Location Address
First Line	:	2919 AVENUE T
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4063
Country	:	US
Telephone Number	:	718-336-4390
Fax Number	:	718-336-4395

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DANIEL RAY DE GRACIA SINDO
Credential	:	PHYSICAL THERAPIST
Telephone Number	:	718-336-4390

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	08/22/2020

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