MEDICARE: BORO PARK PHYSICAL THERAPY 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	032431	NY

General Provider Information

NPI Number	:	1265753420
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BORO PARK PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	1367 51ST ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-3527
Country	:	US
Telephone Number	:	718-673-5424
Fax Number	:	347-673-2176

Provider Business Practice Location Address
First Line	:	5608 NEW UTRECHT AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4631
Country	:	US
Telephone Number	:	718-673-5424
Fax Number	:	347-673-2176

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	DR. YEHUDA Y LITVINTCHOUK
Credential	:	D.P.T.
Telephone Number	:	718-673-5424

Provider Enumeration Date	:	06/22/2010
Last Update Date	:	06/26/2012

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