MEDICARE: BROOKLYN 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	261QP2000X	Physical Therapy Clinic/Center	031324	NY

General Provider Information

NPI Number	:	1528300480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKLYN PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	68 JAY ST
Second Line	:	SUITE 507
City	:	BROOKLYN
State	:	NY
Zip	:	11201-1189
Country	:	US
Telephone Number	:	718-772-5700
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 JAY ST
Second Line	:	SUITE 507
City	:	BROOKLYN
State	:	NY
Zip	:	11201-1189
Country	:	US
Telephone Number	:	718-772-5700
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. NOEL LOZARES
Credential	:	DPT
Telephone Number	:	212-961-6686

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	03/19/2013

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