Healthcare Provider Details

I. General information

NPI: 1679780217
Provider Name (Legal Business Name): REBECCA MARIE CALAUTTI PTA PHYSICAL THERAPI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 JEFFERSON HEIGHTS RD
CATSKILL NY
12414
US

IV. Provider business mailing address

71 PROSPECT AVE
HUDSON NY
12534
US

V. Phone/Fax

Practice location:
  • Phone: 518-943-9380
  • Fax: 518-943-2306
Mailing address:
  • Phone: 518-828-7601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number0058111
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: