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NPI Code Detail

MEDICARE: ACTIVE CARE GROUP PHYSICAL THERAPY PLLC

MEDICARE: ACTIVE CARE GROUP 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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1700665676
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVE CARE GROUP PHYSICAL THERAPY PLLC
Provider Business Mailing Address
First Line : 741 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-6233
Country : US
Telephone Number : 718-400-7200
Fax Number : 718-400-7002
Provider Business Practice Location Address
First Line : 741 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-6233
Country : US
Telephone Number : 718-400-7200
Fax Number : 718-400-7002
Authorized Official
Title or Position : PRRSIDENT
Name : GEORGE TAWDROS
Credential :
Telephone Number : 718-400-7200
Provider Enumeration Date : 09/28/2023
Last Update Date : 01/25/2024

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Directions to “ACTIVE CARE GROUP PHYSICAL THERAPY PLLC ” Practice Location

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