Ellen C Bodner, DPT
Individual provider Active NPI Physical Therapist · Oakland Gardens, NY
NPI 1285634725 · NPPES record last updated Sep 23, 2011
Key facts
- NPI
- 1285634725
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- NYS4201 (NY)
- Practice address
- 20809 Union Tpke
Oakland Gardens, NY 11364-3235 - Phone
- (718) 479-6370
- Fax
- (718) 464-0954
- NPI assigned
- Jul 27, 2005
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NYS4201 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NYS4201 | NY | Yes |
Addresses
Primary practice location
20809 Union Tpke
Oakland Gardens, NY 11364-3235
Mailing address
20809 Union Tpke
Oakland Gardens, NY 11364-3235
Phone (718) 479-6370
Other providers in Oakland Gardens, NY
- Anjali Bhaisin
- Shamsul Alam Bhuiyan
- Bruce Michael Bieber
- Ludmila Birk
- Harry Blaustein
- BP Dental Solutions PC
- Lizmar Brosnan
- Robert M Bullock
- Finela Daedre Pua Cabanding
- Kathleen Caltabiano
All providers in Oakland Gardens, 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 Sep 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.