MEDICARE: RENEE GERBER 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

General Provider Information

NPI Number	:	1730968959
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEE GERBER PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	6315 75TH ST
Second Line	:
City	:	MIDDLE VILLAGE
State	:	NY
Zip	:	11379-1817
Country	:	US
Telephone Number	:	347-834-3161
Fax Number	:

Provider Business Practice Location Address
First Line	:	6315 75TH ST
Second Line	:
City	:	MIDDLE VILLAGE
State	:	NY
Zip	:	11379-1817
Country	:	US
Telephone Number	:	347-834-3161
Fax Number	:

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	DR. RENEE GERBER
Credential	:	DPT
Telephone Number	:	347-834-3161

Provider Enumeration Date	:	09/26/2023
Last Update Date	:	09/26/2023

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