Provider Demographics
NPI:1720210636
Name:OCEAN ONE PHYSICAL THERAPY,PC
Entity Type:Organization
Organization Name:OCEAN ONE PHYSICAL THERAPY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSHAY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-934-5395
Mailing Address - Street 1:2518 OCEAN AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3916
Mailing Address - Country:US
Mailing Address - Phone:718-934-5395
Mailing Address - Fax:718-616-0921
Practice Address - Street 1:2518 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3916
Practice Address - Country:US
Practice Address - Phone:718-934-5395
Practice Address - Fax:718-616-0921
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030921-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY030921-1OtherLICENSE NUMBER