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NPI Code Detail

MEDICARE: PHOENIX PHYSICAL THERAPY REHABILITATION, PLLC

MEDICARE: PHOENIX PHYSICAL THERAPY REHABILITATION, 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
1225100000XPhysical Therapist037286NY
2225100000XPhysical Therapist037502NY
3225100000XPhysical Therapist035548NY

General Provider Information

NPI Number : 1518315274
Entity Type Code : Organization
Provider Name (Legal Business Name) : PHOENIX PHYSICAL THERAPY REHABILITATION, PLLC
Provider Business Mailing Address
First Line : 7510 4TH AVE
Second Line : STE# 3
City : BROOKLYN
State : NY
Zip : 11209-3244
Country : US
Telephone Number : 347-733-1916
Fax Number : 929-292-2329
Provider Business Practice Location Address
First Line : 7510 4TH AVE
Second Line : STE# 3
City : BROOKLYN
State : NY
Zip : 11209-3244
Country : US
Telephone Number : 347-733-1916
Fax Number : 929-292-2329
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : ANTONIOUS BESHET
Credential : PT
Telephone Number : 347-733-1916
Provider Enumeration Date : 06/02/2016
Last Update Date : 01/30/2024

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Directions to “PHOENIX PHYSICAL THERAPY REHABILITATION, PLLC ” Practice Location

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