MEDICARE: COLIN O'BANION DPT

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	2251X0800X	Orthopedic Physical Therapist	028692	NY

General Provider Information

NPI Number	:	1851481303
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLIN O'BANION DPT

Provider Business Mailing Address
First Line	:	349 W BROADWAY APT 5
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-2241
Country	:	US
Telephone Number	:	928-600-4886
Fax Number	:

Provider Business Practice Location Address
First Line	:	2109 BROADWAY STE 204
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10023-2106
Country	:	US
Telephone Number	:	212-799-0160
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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Directions to “ COLIN O'BANION DPT” Practice Location

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