Individual
BRANDON PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
233 BROADWAY RM 1775, NEW YORK, NY 10279-1810
(212) 921-7900
Mailing address
233 BROADWAY RM 1775, NEW YORK, NY 10279-1810
(212) 921-7900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
050567
NY
Other
Enumeration date
08/16/2023
Last updated
02/11/2025
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