Provider Demographics
NPI:1609431576
Name:MAIMONIDES BONE AND JOINT FACULTY PRACTICE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MAIMONIDES BONE AND JOINT FACULTY PRACTICE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSITARTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRO
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MS, MBA
Authorized Official - Phone:718-283-6087
Mailing Address - Street 1:6010 BAY PKWY FL 1
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-6079
Mailing Address - Country:US
Mailing Address - Phone:718-283-8962
Mailing Address - Fax:718-635-8962
Practice Address - Street 1:6010 BAY PKWY FL 1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-6079
Practice Address - Country:US
Practice Address - Phone:718-283-8962
Practice Address - Fax:718-635-8962
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAIMONIDES MEDICAL CENTER ORTHOPAEDIC FPP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-07
Last Update Date:2019-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation