Provider Demographics
NPI:1306511050
Name:TAYLOR, THOMAS PHILLIP (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PHILLIP
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:288 BAY 38TH ST APT 3N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6516
Mailing Address - Country:US
Mailing Address - Phone:929-352-6372
Mailing Address - Fax:
Practice Address - Street 1:2420 ARTHUR KILL RD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1212
Practice Address - Country:US
Practice Address - Phone:212-356-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-14
Last Update Date:2022-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047290225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist