MEDICARE: ASSIST 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	039320	NY

General Provider Information

NPI Number	:	1447736863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSIST PHYSICAL THERAPY, PLLC

Provider Business Mailing Address
First Line	:	2388 OCEAN AVE STE MO
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3564
Country	:	US
Telephone Number	:	718-775-8966
Fax Number	:	718-744-2840

Provider Business Practice Location Address
First Line	:	2388 OCEAN AVE STE MO
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3564
Country	:	US
Telephone Number	:	718-775-8966
Fax Number	:	718-744-2840

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	VLADIMIR YELYEV
Credential	:	PT, DPT
Telephone Number	:	718-775-8966

Provider Enumeration Date	:	07/18/2018
Last Update Date	:	07/18/2018

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