Provider Demographics
NPI:1609937101
Name:DUFFY & BRACKEN PHYSICAL THERAPY P.C.
Entity Type:Organization
Organization Name:DUFFY & BRACKEN PHYSICAL THERAPY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:212-402-5430
Mailing Address - Street 1:75 MAIDEN LN
Mailing Address - Street 2:404
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10038-4810
Mailing Address - Country:US
Mailing Address - Phone:212-402-5430
Mailing Address - Fax:212-402-5432
Practice Address - Street 1:75 MAIDEN LN
Practice Address - Street 2:404
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4810
Practice Address - Country:US
Practice Address - Phone:212-402-5430
Practice Address - Fax:212-402-5432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNS542OtherOXFORD
NYQ0WKJ1Medicare PIN