Provider Demographics
NPI:1265753420
Name:BORO PARK PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:BORO PARK PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:YEHUDA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LITVINTCHOUK
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:718-673-5424
Mailing Address - Street 1:1367 51ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3527
Mailing Address - Country:US
Mailing Address - Phone:718-673-5424
Mailing Address - Fax:347-673-2176
Practice Address - Street 1:5608 NEW UTRECHT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-4631
Practice Address - Country:US
Practice Address - Phone:718-673-5424
Practice Address - Fax:347-673-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032431225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty