MEDICARE: AG RECOVERY

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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1487503934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AG RECOVERY

Provider Business Mailing Address
First Line	:	1240 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5404
Country	:	US
Telephone Number	:	347-267-2993
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 E 19TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5404
Country	:	US
Telephone Number	:	347-267-2993
Fax Number	:

Authorized Official
Title or Position	:	PTA
Name	:	MRS. ALIS GAMZEHLATOVA
Credential	:	PTA
Telephone Number	:	347-267-2993

Provider Enumeration Date	:	01/27/2026
Last Update Date	:	01/27/2026

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Directions to “AG RECOVERY ” Practice Location

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