| Doctor Name: | MS. AIYSHA R GLENN-BRADBY |
| NPI Number: | 1851429450 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT, CLT |
| License Number: | |
| Business Practice Address: | 17660 Union Tpke Suite 195 Fresh Meadows, NY - 113661526 |
| Business Phone Number: | 7188209300 |
| Business Fax Number: | 7188209382 |
| Mailing Address: | 17660 Union Tpke, Suite 195 FRESH MEADOWS |
| State: | NY |
| Postal Code: | 113661526 |
| Phone Number: | 7188209300 |
| Fax Number: | 7188209382 |
| NPI Enumeration Date: | 03/02/2007 |
| NPI Last Update Date: | 03/07/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |