Provider Demographics
NPI:1770537763
Name:MUNIZ, ERIC (MS, PT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:MUNIZ
Suffix:
Gender:M
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 72ND ST
Mailing Address - Street 2:APT. 4C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-2063
Mailing Address - Country:US
Mailing Address - Phone:917-345-2043
Mailing Address - Fax:
Practice Address - Street 1:710 PARKSIDE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1508
Practice Address - Country:US
Practice Address - Phone:718-282-7800
Practice Address - Fax:718-282-7838
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026874-1225100000X
AZ7207225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist