Provider Demographics
NPI:1275796146
Name:EHRENBERG, STUART (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:
Last Name:EHRENBERG
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5406
Mailing Address - Country:US
Mailing Address - Phone:718-788-1446
Mailing Address - Fax:718-788-1446
Practice Address - Street 1:293 18TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5406
Practice Address - Country:US
Practice Address - Phone:718-788-1446
Practice Address - Fax:718-788-1446
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014679-12251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics