Healthcare Provider Details

I. General information

NPI: 1649842378
Provider Name (Legal Business Name): EMILY GUBBINS PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2021
Last Update Date: 02/05/2026
Certification Date: 02/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51ST MEDICAL GROUP UNIT 2060
APO AP
96278
KR

IV. Provider business mailing address

6281 SKINNER RD
ROME NY
13440-1253
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone: 315-617-2606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number046831-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: