Provider Demographics
NPI:1952977787
Name:BRAVER, BERNARD DANIEL (PT)
Entity Type:Individual
Prefix:
First Name:BERNARD
Middle Name:DANIEL
Last Name:BRAVER
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 1:535 FLUSHING AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-1610
Mailing Address - Country:US
Mailing Address - Phone:718-488-7272
Mailing Address - Fax:
Practice Address - Street 1:535 FLUSHING AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-1610
Practice Address - Country:US
Practice Address - Phone:718-488-7272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY047036OtherLISENCE