Diana L. Brooks, PT

Individual provider Active NPI Pediatric Physical Therapist · Red Hook, NY

NPI 1093965253 · NPPES record last updated Sep 24, 2008

Key facts

NPI
1093965253
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Physical Therapist 2251P0200X
License
011612-1 (NY)
Practice address
73 Kelly Rd
Red Hook, NY 12571-1122
Phone
(845) 758-0660
NPI assigned
Sep 24, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
011612-1NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 011612-1 NY
Pediatric Physical Therapist 2251P0200X 011612-1 NY Yes

Addresses

Primary practice location

73 Kelly Rd
Red Hook, NY 12571-1122

Mailing address

73 Kelly Rd
Red Hook, NY 12571-1122
Phone (845) 758-0660

Other providers in Red Hook, NY

All providers in Red Hook, NY · Pediatric Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.