Krystal F Clarke, DPT
Individual provider Active NPI Physical Therapist · Scotia, NY
NPI 1124280433 · NPPES record last updated Apr 6, 2011
Key facts
- NPI
- 1124280433
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 030408-1 (NY)
- Practice address
- 42 Saratoga Rd
Scotia, NY 12302-3412 - Phone
- (518) 399-6861
- Fax
- (518) 399-6864
- NPI assigned
- Jun 27, 2008
- 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)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030408-1 | NY | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 030408-1 | NY | Yes |
Addresses
Primary practice location
42 Saratoga Rd
Scotia, NY 12302-3412
Mailing address
42 Saratoga Rd
Scotia, NY 12302-3412
Phone (518) 399-6861
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56563A | Other | NY | MEDICARE |
Other providers in Scotia, NY
- David J Cerniglia
- Alexander Joseph Chlopecki II
- Holly Ciarmiello
- Nicholas John Ciotoli
- David Thomas Civale
- Cmac II Property MGMT Group
- Ralph N. Comanzo
- David Michael Coppola
- Cristiana Couchman
- Mary B Cremo
All providers in Scotia, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.