Edward S Brubaker, MS, PT
Individual provider Active NPI Physical Therapist · Tarrytown, NY
NPI 1104997709 · NPPES record last updated Oct 22, 2019
Key facts
- NPI
- 1104997709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 019319 (NY)
- Practice address
- 333 Carroll Close
Tarrytown, NY 10591-5217 - Phone
- (914) 588-1786
- NPI assigned
- Nov 13, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120830000701 | NY | Practitioner - Physical Therapist in Private Practice | 4486867215 | Practice locations: Tarrytown, NY |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 019319 | NY | Yes |
Addresses
Primary practice location
333 Carroll Close
Tarrytown, NY 10591-5217
Mailing address
333 Carroll Close
Tarrytown, NY 10591-5217
Phone (914) 588-1786
Other providers in Tarrytown, NY
- Bridge Dermatopathology Services PLLC
- Broadway Cosmetic Dentistry, P.C.
- Broadway PT Corp
- Kelly Ann Brown
- Olga Brown
- Patricia Coffey Bucci
- Ronald John Bucci
- Cameron Lind Budenz
- Jessica Marie Burckhard
- Marra Burroughs
All providers in Tarrytown, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.