Healthcare Provider Details

I. General information

NPI: 1225978448
Provider Name (Legal Business Name): MICHELLE CUAHUIZO PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

887A E NEW YORK AVE
BROOKLYN NY
11203-1309
US

IV. Provider business mailing address

362 AVENUE W
BROOKLYN NY
11223-5350
US

V. Phone/Fax

Practice location:
  • Phone: 718-221-1022
  • Fax: 718-221-1009
Mailing address:
  • Phone: 929-433-9372
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number015226
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: