Provider Demographics
NPI:1700340742
Name:BEND THE KNEE
Entity Type:Organization
Organization Name:BEND THE KNEE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHIVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRIQUES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-771-9363
Mailing Address - Street 1:282 E 35TH ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3933
Mailing Address - Country:US
Mailing Address - Phone:732-771-9363
Mailing Address - Fax:
Practice Address - Street 1:282 E 35TH ST APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-3933
Practice Address - Country:US
Practice Address - Phone:732-771-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty