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Organization
YAD OT PT PLLC
Active
Organization
YAD OT PT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID J ETTINGER PT (MANAGING MEMBER)
(718) 336-4900
Entity
Organization
Contact information
Practice address
1716 CONEY ISLAND AVE, BROOKLYN, NY 11230-5801
(718) 336-4900
Mailing address
1565 E 36TH ST, BROOKLYN, NY 11234-3415
(917) 658-7726
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
029579
NY
Other
Enumeration date
10/14/2014
Last updated
01/23/2015
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