Provider Demographics
NPI:1275397333
Name:WALKER, BRETT AUSTIN (PT, DPT, MPH)
Entity Type:Individual
Prefix:
First Name:BRETT
Middle Name:AUSTIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:PT, DPT, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1063 WILLIS AVE
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1334
Mailing Address - Country:US
Mailing Address - Phone:516-656-7776
Mailing Address - Fax:
Practice Address - Street 1:1063 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:ALBERTSON
Practice Address - State:NY
Practice Address - Zip Code:11507-1334
Practice Address - Country:US
Practice Address - Phone:516-656-7776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-09
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051989225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist