Provider Demographics
NPI:1528173440
Name:GURNEY, BRIAN PAUL (PT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:PAUL
Last Name:GURNEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 BROADWAY
Mailing Address - Street 2:1115
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036-1537
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1560 BROADWAY
Practice Address - Street 2:1115
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-1537
Practice Address - Country:US
Practice Address - Phone:212-256-0445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0280031225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ073E1Medicare PIN