MEDICARE: BRIDGE PT, OT & SPEECH SERVICES, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225100000X	Physical Therapist
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	171W00000X	Contractor

General Provider Information

NPI Number	:	1336081181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIDGE PT, OT & SPEECH SERVICES, PLLC

Provider Business Mailing Address
First Line	:	16316 84TH ST
Second Line	:
City	:	HOWARD BEACH
State	:	NY
Zip	:	11414-3319
Country	:	US
Telephone Number	:	718-541-3575
Fax Number	:

Provider Business Practice Location Address
First Line	:	16316 84TH ST
Second Line	:
City	:	HOWARD BEACH
State	:	NY
Zip	:	11414-3319
Country	:	US
Telephone Number	:	718-541-3575
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. JUSTINE CLIFFORD
Credential	:	DPT
Telephone Number	:	718-541-3575

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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