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NPI Code Detail

MEDICARE: ALINA FATAKHOVA PT, DPT

MEDICARE:   ALINA  FATAKHOVA  PT, 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
1225100000XPhysical Therapist043158-1NY

General Provider Information

NPI Number : 1962097618
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALINA FATAKHOVA PT, DPT
Provider Business Mailing Address
First Line : 202 UNION AVE STE K
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-7467
Country : US
Telephone Number : 718-387-7420
Fax Number : 718-387-7421
Provider Business Practice Location Address
First Line : 202 UNION AVE STE K
Second Line :
City : BROOKLYN
State : NY
Zip : 11211-7467
Country : US
Telephone Number : 718-387-7420
Fax Number : 718-387-7421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2021
Last Update Date : 03/04/2021

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Directions to “ ALINA FATAKHOVA PT, DPT” Practice Location

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