Provider Demographics
NPI:1417094608
Name:BRAUER, DAWN P (MSPT, CIMI)
Entity Type:Individual
Prefix:MRS
First Name:DAWN
Middle Name:P
Last Name:BRAUER
Suffix:
Gender:F
Credentials:MSPT, CIMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BRIARBERRY CT
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2232
Mailing Address - Country:US
Mailing Address - Phone:631-431-6824
Mailing Address - Fax:631-580-5378
Practice Address - Street 1:7 BRIARBERRY CT
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2232
Practice Address - Country:US
Practice Address - Phone:631-431-6824
Practice Address - Fax:631-580-5378
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019793225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist