Provider Demographics
NPI:1376726117
Name:STEP INTO STRIDE P.T., P.C.
Entity Type:Organization
Organization Name:STEP INTO STRIDE P.T., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:MABREY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:347-446-8579
Mailing Address - Street 1:433 77TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3205
Mailing Address - Country:US
Mailing Address - Phone:718-921-8780
Mailing Address - Fax:718-921-8768
Practice Address - Street 1:6917 SHORE RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-1000
Practice Address - Country:US
Practice Address - Phone:718-921-8780
Practice Address - Fax:718-921-8768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-16
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022939-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ5W3L1Medicare PIN