Provider Demographics
NPI:1699024067
Name:BRICK, AMANDA J (DPT)
Entity Type:Individual
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First Name:AMANDA
Middle Name:J
Last Name:BRICK
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Gender:F
Credentials:DPT
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Mailing Address - Street 1:333 EARLE OVINGTON BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3610
Mailing Address - Country:US
Mailing Address - Phone:516-321-2400
Mailing Address - Fax:516-321-2424
Practice Address - Street 1:32 UNION SQ E
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3209
Practice Address - Country:US
Practice Address - Phone:212-677-3989
Practice Address - Fax:212-677-3994
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2014-07-03
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Provider Licenses
StateLicense IDTaxonomies
NY035399-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ4WFH1Medicare PIN