Provider Demographics
NPI:1811912314
Name:BABIEC, GREG (PT)
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:BABIEC
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 E 74TH ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-3235
Mailing Address - Country:US
Mailing Address - Phone:212-439-1596
Mailing Address - Fax:212-439-1608
Practice Address - Street 1:159 E 74TH ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-3235
Practice Address - Country:US
Practice Address - Phone:212-439-1596
Practice Address - Fax:212-439-1608
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0220931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ00K31Medicare ID - Type Unspecified