Doctor Name: | MR. TODD M BORNFRIEND |
NPI Number: | 1891897591 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 014267-1 |
Business Practice Address: | 660 Broadway Massapequa, NY - 117582391 |
Business Phone Number: | 5167302222 |
Business Fax Number: | 5167302244 |
Mailing Address: | 1728 Sunrise Hwy, MERRICK |
State: | NY |
Postal Code: | 115663745 |
Phone Number: | 5169224700 |
Fax Number: | 5165362621 |
NPI Enumeration Date: | 09/02/2006 |
NPI Last Update Date: | 10/02/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 014267-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |