MEDICARE: FREE STEPS 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	042872	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1871115527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREE STEPS PHYSICAL THERAPY PC

Provider Business Mailing Address
First Line	:	1247 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11228-2016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 BELMONT AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11212-6705
Country	:	US
Telephone Number	:	718-684-3319
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	HANY ELMELIGY
Credential	:	PT
Telephone Number	:	929-509-8521

Provider Enumeration Date	:	05/15/2020
Last Update Date	:	05/15/2020

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