Provider Demographics
NPI:1720395643
Name:KATZ-BRAUNSCHWEIG, GLORIA P (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:P
Last Name:KATZ-BRAUNSCHWEIG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:GLORIA
Other - Middle Name:P
Other - Last Name:MAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:229 PRINCETON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-4238
Mailing Address - Country:US
Mailing Address - Phone:718-504-7347
Mailing Address - Fax:718-769-4844
Practice Address - Street 1:475 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3436
Practice Address - Country:US
Practice Address - Phone:718-226-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist