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Organization
DEER PARK PHYSICAL THERAPY & CHIROPRACTIC
Active
Organization
DEER PARK PHYSICAL THERAPY & CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD BREDOW MS, PT (PHYSICAL THERAPY, OWNER)
(516) 315-2010
Entity
Organization
Contact information
Practice address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 242-4500
(631) 242-0885
Mailing address
2103 DEER PARK AVE, DEER PARK, NY 11729-1319
(631) 242-4500
(631) 242-0885
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
021022-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401575
CIGNA
NY
01
—
2166308
UHC
NY
01
—
825077
ACN
NY
01
—
P3369855
OXFORD
—
01
—
Q13V53
BCBS
—
Enumeration date
09/16/2014
Last updated
09/16/2014
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