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Organization
DEER PARK PHYSICAL THERAPY AND CHIROPRACTIC PLLC
Active
Organization
DEER PARK PHYSICAL THERAPY AND CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH BREDOW MS, PT (OWNER, PHYSICAL THERAPIST)
(631) 242-4500
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
225100000X
Physical Therapist
Primary
021022-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401575
CIGNA
—
01
—
6697450
GHI
—
01
—
771360P
HIP
—
01
—
P3369855
OXFORD
NY
01
—
Q13V53
BCBS
NY
Enumeration date
07/23/2014
Last updated
05/13/2015
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