MEDICARE: WEST POINT PHYSICAL AND OCCUPATIONAL THERAPIST 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
2	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1578798484
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST POINT PHYSICAL AND OCCUPATIONAL THERAPIST PLLC

Provider Business Mailing Address
First Line	:	2802 ALBEMARLE RD FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5037
Country	:	US
Telephone Number	:	718-812-7082
Fax Number	:

Provider Business Practice Location Address
First Line	:	2802 ALBEMARLE RD FL 3
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11226-5037
Country	:	US
Telephone Number	:	718-812-7082
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	KENNEDY OPOKU
Credential	:
Telephone Number	:	718-812-7082

Provider Enumeration Date	:	05/20/2009
Last Update Date	:	05/20/2009

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