MEDICARE: BODY

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

General Provider Information

NPI Number	:	1902761323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BODY

Provider Business Mailing Address
First Line	:	6 LITCHULT CT
Second Line	:
City	:	AIRMONT
State	:	NY
Zip	:	10901-7511
Country	:	US
Telephone Number	:	347-605-7946
Fax Number	:	718-585-0880

Provider Business Practice Location Address
First Line	:	8686 BAY PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-5119
Country	:	US
Telephone Number	:	347-605-7946
Fax Number	:	718-585-0880

Authorized Official
Title or Position	:	CEO
Name	:	MR. MICHAEL KRISTIAN MANGUBAT
Credential	:
Telephone Number	:	347-605-7946

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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Directions to “BODY ” Practice Location

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