Nancvy C Kinney, PHYSICAL THERAPIST

Individual provider Active NPI Physical Therapist · Centerport, NY

NPI 1013063270 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013063270
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
2311-1 (NY)
Practice address
406 Coolidge Dr
Centerport, NY 11721-1206
Phone
(631) 424-2001
Fax
(631) 424-2001
NPI assigned
Jan 28, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2311-1NYMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2311-1 NY Yes

Addresses

Primary practice location

406 Coolidge Dr
Centerport, NY 11721-1206

Mailing address

406 Coolidge Dr
Centerport, NY 11721-1206
Phone (631) 424-2001

Other providers in Centerport, NY

All providers in Centerport, NY · Physical Therapist in New York

Sources for this page

Verify at the official NPI Registry.