MEDICARE: MS. NATALLIA HUTMAN DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	19068	MA
2	225100000X	Physical Therapist	035024	NY

General Provider Information

NPI Number	:	1043521396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NATALLIA HUTMAN DPT

Provider Business Mailing Address
First Line	:	1855 RICHMOND AVE STE 104
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3912
Country	:	US
Telephone Number	:	718-880-8571
Fax Number	:	718-556-7868

Provider Business Practice Location Address
First Line	:	1855 RICHMOND AVE STE 104
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3912
Country	:	US
Telephone Number	:	718-880-8571
Fax Number	:	718-556-7868

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2010
Last Update Date	:	09/19/2018

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