Healthcare Provider Details

I. General information

NPI: 1063710788
Provider Name (Legal Business Name): SILVIA KUPER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 03/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 W END AVE APT 7A
NEW YORK NY
10025-3526
US

IV. Provider business mailing address

890 W END AVE APT 7A
NEW YORK NY
10025-3526
US

V. Phone/Fax

Practice location:
  • Phone: 917-975-8785
  • Fax:
Mailing address:
  • Phone: 917-975-8785
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number007496-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: