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NPI Code Detail

MEDICARE: MRS. CARLENE NOELLE KUCZMA MPT

MEDICARE: MRS. CARLENE NOELLE KUCZMA MPT
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
1225100000XPhysical Therapist021717-01NY

General Provider Information

NPI Number : 1942418645
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARLENE NOELLE KUCZMA MPT
Provider Business Mailing Address
First Line : 137 SHAGBARK LN
Second Line :
City : HOPEWELL JUNCTION
State : NY
Zip : 12533-5281
Country : US
Telephone Number : 845-592-0739
Fax Number : 845-592-0739
Provider Business Practice Location Address
First Line : 200 BOCES DR
Second Line : PINES BRIDGE SCHOOL
City : YORKTOWN HEIGHTS
State : NY
Zip : 10598-4321
Country : US
Telephone Number : 914-248-2257
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 07/08/2007

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