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NPI Code Detail

MEDICARE: BORO PARK PHYSICAL FITNESS LLC

MEDICARE: BORO PARK PHYSICAL FITNESS LLC
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
1225100000XPhysical Therapist031012NY

General Provider Information

NPI Number : 1114302924
Entity Type Code : Organization
Provider Name (Legal Business Name) : BORO PARK PHYSICAL FITNESS LLC
Provider Business Mailing Address
First Line : 5608 NEW UTRECHT AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4631
Country : US
Telephone Number : 718-947-6288
Fax Number :
Provider Business Practice Location Address
First Line : 5608 NEW UTRECHT AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4631
Country : US
Telephone Number : 718-947-6288
Fax Number :
Authorized Official
Title or Position : CEO
Name : NEIL MOSKOVITZ
Credential : DPT
Telephone Number : 718-947-6288
Provider Enumeration Date : 07/22/2015
Last Update Date : 07/22/2015

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Directions to “BORO PARK PHYSICAL FITNESS LLC ” Practice Location

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