Provider Demographics
NPI:1285145524
Name:JONATHAN LOCITZER PHYSICAL THERAPY P.C
Entity type:Organization
Organization Name:JONATHAN LOCITZER PHYSICAL THERAPY P.C
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/SUPERVISOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:RAPHAEL
Authorized Official - Last Name:LOCITZER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:347-294-0795
Mailing Address - Street 1:104 1ST PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-5120
Mailing Address - Country:US
Mailing Address - Phone:347-294-0795
Mailing Address - Fax:
Practice Address - Street 1:104 1ST PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-5120
Practice Address - Country:US
Practice Address - Phone:347-294-0795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029536-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty