National Provider Identifier

Benjamin Taillie, PT

Benjamin Taillie, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Brockport, NY and a listed phone number of (585) 637-0790.

NPI 1528730348Brockport, NYPhysical Therapist

Profile Overview

NPI
1528730348
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
September 30, 2021
Last Updated
November 28, 2023

Practice Location

  • 92 West Ave
  • Brockport, NY 14420-1306

Phone: (585) 637-0790

Specialties

  • Physical Therapist (225100000X)
  • Physical Therapist (225100000X)
Full Record
NPI
1528730348
Entity Type
Individual
Last Name
Taillie
First Name
Benjamin
Credential
PT
Mailing Street Address
92 West Ave
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-1306
Mailing Country
US
Mailing Phone
(585) 637-0790
Mailing Fax
(585) 637-3572
Practice Street Address
92 West Ave
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1306
Practice Country
US
Practice Phone
(585) 637-0790
Practice Fax
(585) 637-3572
Enumeration Date
September 30, 2021
Last Updated
November 28, 2023
Sex
Male
Sole Proprietor
No
Certification Date
November 28, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X), Physical Therapist (225100000X)