Rachel Elizabeth Petkovsek

Individual provider Active NPI Physical Therapy Assistant · Frankfort, NY

NPI 1316465883 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1316465883
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
006549-1 (NY)
Practice address
325 Fifth Avenue
Frankfort, NY 13340
Phone
(315) 717-7442
Fax
(315) 895-0062
NPI assigned
Sep 6, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
006549-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Simply Special Early Learning Center LLC Past
since Jul 24, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 006549-1 NY Yes

Addresses

Primary practice location

325 Fifth Avenue
Frankfort, NY 13340

Mailing address

325 5TH Ave
Frankfort, NY 13340-3622
Phone (315) 717-7442

Other providers in Frankfort, NY

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

Sources for this page

Verify at the official NPI Registry.