Kathy Bruetsch

Individual provider Active NPI Physical Therapy Assistant · Oneonta, NY

NPI 1043663586 · NPPES record last updated Jul 20, 2016

Key facts

NPI
1043663586
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
004017-1 (NY)
Practice address
1 Foxcare Dr
Oneonta, NY 13820-2099
Phone
(607) 431-5702
Fax
(607) 431-5709
NPI assigned
Jul 20, 2016
Sex
Female
Sole proprietor
No

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
004017-1NYMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 004017-1 NY Yes

Addresses

Primary practice location

1 Foxcare Dr
Oneonta, NY 13820-2099

Mailing address

1 Foxcare Drive
Oneonta, NY 13820-2086
Phone (607) 431-5702

Other identifiers

IdentifierTypeStateIssuer
00279098MedicaidNY
330085OtherNYFACILITY MEDICARE #

Other providers in Oneonta, NY

All providers in Oneonta, NY · Physical Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.