MEDICARE: AMALA CRISTEENA ANTONY

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	049413-01	NY

General Provider Information

NPI Number	:	1114803806
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMALA CRISTEENA ANTONY

Provider Business Mailing Address
First Line	:	723 PATTERSON AVE
Second Line	:
City	:	FRANKLIN SQUARE
State	:	NY
Zip	:	11010-4107
Country	:	US
Telephone Number	:	516-738-9059
Fax Number	:

Provider Business Practice Location Address
First Line	:	723 PATTERSON AVE
Second Line	:
City	:	FRANKLIN SQUARE
State	:	NY
Zip	:	11010-4107
Country	:	US
Telephone Number	:	516-738-9059
Fax Number	:

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

Provider Enumeration Date	:	08/15/2025
Last Update Date	:	10/08/2025

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Directions to “ AMALA CRISTEENA ANTONY ” Practice Location

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