Provider Demographics
NPI:1962730275
Name:DOMBAL, BRIAN JAMES (DPT)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:DOMBAL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7 WATCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2534
Mailing Address - Country:US
Mailing Address - Phone:914-202-0700
Mailing Address - Fax:914-202-0700
Practice Address - Street 1:5 N GREENWICH RD
Practice Address - Street 2:
Practice Address - City:ARMONK
Practice Address - State:NY
Practice Address - Zip Code:10504-2311
Practice Address - Country:US
Practice Address - Phone:914-202-0700
Practice Address - Fax:914-202-0700
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2020-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY032100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist