Provider Demographics
NPI:1821109752
Name:FEEL GOOD PHYSICAL THERAPY, PC
Entity Type:Organization
Organization Name:FEEL GOOD PHYSICAL THERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAKHTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:718-714-6995
Mailing Address - Street 1:1057 CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2616
Mailing Address - Country:US
Mailing Address - Phone:917-837-1268
Mailing Address - Fax:718-714-9346
Practice Address - Street 1:2993 OCEAN PARKWAY
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-714-6995
Practice Address - Fax:719-714-9346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020674174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02216439Medicaid
NYQ2WMM1Medicare PIN