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NPI Code Detail

MEDICARE: VISITING REHAB PT OT SLP PLLC

MEDICARE: VISITING REHAB PT OT SLP 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
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1134747884
Entity Type Code : Organization
Provider Name (Legal Business Name) : VISITING REHAB PT OT SLP PLLC
Provider Business Mailing Address
First Line : 3911 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3501
Country : US
Telephone Number : 718-377-5000
Fax Number : 718-377-5002
Provider Business Practice Location Address
First Line : 3911 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-3501
Country : US
Telephone Number : 718-377-5000
Fax Number : 718-377-5002
Authorized Official
Title or Position : MANAGING MEMBER
Name : YISROEL BRODY
Credential : DPT
Telephone Number : 718-377-5000
Provider Enumeration Date : 07/09/2020
Last Update Date : 07/09/2020

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Directions to “VISITING REHAB PT OT SLP PLLC ” Practice Location

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