Provider Demographics
NPI:1124277611
Name:MISCH, GREGORY E (MPT)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:E
Last Name:MISCH
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Gender:M
Credentials:MPT
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Mailing Address - Street 1:333 EARLE OVINGTON BLVD
Mailing Address - Street 2:SUITE 225
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3610
Mailing Address - Country:US
Mailing Address - Phone:516-321-2400
Mailing Address - Fax:516-321-2424
Practice Address - Street 1:30 BROAD ST
Practice Address - Street 2:12TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2304
Practice Address - Country:US
Practice Address - Phone:212-587-8606
Practice Address - Fax:212-587-9024
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2014-07-30
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Provider Licenses
StateLicense IDTaxonomies
NY028066225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ4WFH1Medicare PIN