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Organization
MICHAEL BARANOV PHYSICAL THERAPY PC
Active
Organization
MICHAEL BARANOV PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL BARANOV PT (OWNER)
(718) 975-3515
Entity
Organization
Contact information
Practice address
4119 18TH AVE, BROOKLYN, NY 11218-5709
(718) 975-3515
(718) 975-3514
Mailing address
15611 AGUILAR AVE # 1018, FLUSHING, NY 11367-2732
(718) 975-3515
(718) 975-3514
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03356723
—
NY
01
—
A100123733
MEDICARE
NY
Enumeration date
06/16/2006
Last updated
10/18/2021
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