MEDICARE: ABILITY OT, PT, SLP 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	225XP0200X	Pediatric Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	261QP2000X	Physical Therapy Clinic/Center	014648-1	NY

General Provider Information

NPI Number	:	1407141674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABILITY OT, PT, SLP THERAPY, PLLC

Provider Business Mailing Address
First Line	:	3514 AVENUE S
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4828
Country	:	US
Telephone Number	:	718-336-3832
Fax Number	:	718-336-2392

Provider Business Practice Location Address
First Line	:	3514 AVENUE S
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4828
Country	:	US
Telephone Number	:	718-336-3832
Fax Number	:	718-336-2392

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ISAAC MATTHEW JACOBOWITZ
Credential	:	PHYSICAL THERAPIST
Telephone Number	:	718-336-3832

Provider Enumeration Date	:	06/15/2011
Last Update Date	:	02/16/2016

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