MEDICARE: CHARLOTTE GRAFIL BRUN 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	225100000X	Physical Therapist	045720	NY

General Provider Information

NPI Number	:	1083552723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE GRAFIL BRUN DPT

Provider Business Mailing Address
First Line	:	5739 VAN HORN ST FL 3
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4851
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1908 AVENUE K
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-4904
Country	:	US
Telephone Number	:	929-329-6775
Fax Number	:

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

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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