Provider Demographics
NPI:1083891063
Name:MIDWOOD PHYSICAL THERAPY OF BROOKLYN, PC
Entity Type:Organization
Organization Name:MIDWOOD PHYSICAL THERAPY OF BROOKLYN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEMBITZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-468-5253
Mailing Address - Street 1:813 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2251
Mailing Address - Country:US
Mailing Address - Phone:917-468-5253
Mailing Address - Fax:718-854-8308
Practice Address - Street 1:813 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2251
Practice Address - Country:US
Practice Address - Phone:917-468-5253
Practice Address - Fax:718-854-8308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty