Provider Demographics
NPI:1982700670
Name:BORNSTEIN, ORIT (RPT)
Entity Type:Individual
Prefix:
First Name:ORIT
Middle Name:
Last Name:BORNSTEIN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12626 RIVERSIDE DR
Mailing Address - Street 2:SUITE #301
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3420
Mailing Address - Country:US
Mailing Address - Phone:818-203-0922
Mailing Address - Fax:818-760-0137
Practice Address - Street 1:12626 RIVERSIDE DR
Practice Address - Street 2:SUITE #301
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3420
Practice Address - Country:US
Practice Address - Phone:818-203-0922
Practice Address - Fax:818-760-0137
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT14020225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT140200OtherBLUE SHEILD
CAPT14020Medicare PIN