# MIRACLE TOUCH PT PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891147088
- **Authorized official:** TATIANA BULANOV MS (PRESIDENT)
- **Authorized official phone:** (917) 882-0550

## Contact information

- **Practice address:** 2543 E 11TH ST, BROOKLYN, NY 11235-5011
- **Practice address phone:** (917) 882-0550
- **Practice address fax:** (718) 615-9409
- **Mailing address:** 2543 E 11TH ST, BROOKLYN, NY 11235-5011
- **Mailing address phone:** (917) 882-0550
- **Mailing address fax:** (718) 615-9409

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 020707 | NY | Yes |

## Other

- **Enumeration date:** 07/12/2016
- **Last updated:** 07/12/2016