Provider Demographics
NPI:1164967683
Name:MIMS, BRITTNEY (DPT)
Entity Type:Individual
Prefix:DR
First Name:BRITTNEY
Middle Name:
Last Name:MIMS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 E 35TH ST APT 14B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4132
Mailing Address - Country:US
Mailing Address - Phone:863-398-1993
Mailing Address - Fax:646-224-9740
Practice Address - Street 1:250 W 26TH ST
Practice Address - Street 2:#402
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6737
Practice Address - Country:US
Practice Address - Phone:863-398-1993
Practice Address - Fax:646-224-9740
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist