MEDICARE: MOTIONPRO PHYSICAL THERAPY PC

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	016043	NY
2	225X00000X	Occupational Therapist	014206	NY
3	225100000X	Physical Therapist	019510	NY

General Provider Information

NPI Number	:	1548683055
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOTIONPRO PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	710 MILL ST UNIT H3
Second Line	:	UNIT H3
City	:	BELLEVILLE
State	:	NJ
Zip	:	07109-5306
Country	:	US
Telephone Number	:	973-759-1494
Fax Number	:	973-759-0557

Provider Business Practice Location Address
First Line	:	346 1ST ST
Second Line	:	FLR 2
City	:	BROOKLYN
State	:	NY
Zip	:	11215-1906
Country	:	US
Telephone Number	:	347-708-9701
Fax Number	:	347-708-9701

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	DR. RICHARD HOLSMAN
Credential	:	PT, DPT, MAT, GCS
Telephone Number	:	718-355-9652

Provider Enumeration Date	:	02/04/2014
Last Update Date	:	03/15/2016

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