Provider Demographics
NPI:1841980638
Name:BRIGHT PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:BRIGHT PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHADY
Authorized Official - Middle Name:
Authorized Official - Last Name:YASSA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:646-404-4273
Mailing Address - Street 1:250 W 50TH ST APT 31F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6729
Mailing Address - Country:US
Mailing Address - Phone:646-404-4273
Mailing Address - Fax:
Practice Address - Street 1:513 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2409
Practice Address - Country:US
Practice Address - Phone:646-404-4273
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy