Provider Demographics
NPI:1497883094
Name:ESTER YUSUPOVA PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:ESTER YUSUPOVA PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSUPOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-495-3668
Mailing Address - Street 1:540 OCEAN PKWY
Mailing Address - Street 2:APT # 4F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-5861
Mailing Address - Country:US
Mailing Address - Phone:718-495-3668
Mailing Address - Fax:
Practice Address - Street 1:540 OCEAN PKWY
Practice Address - Street 2:APT #4F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5861
Practice Address - Country:US
Practice Address - Phone:718-495-3668
Practice Address - Fax:718-495-3665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024736225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty