Healthcare Provider Details

I. General information

NPI: 1083926265
Provider Name (Legal Business Name): TING-TING KUO PT,DPT,WCS,CLT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2010
Last Update Date: 07/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W 42ND ST APT 38F
NEW YORK NY
10036-6945
US

IV. Provider business mailing address

350 W 42ND ST APT 38F
NEW YORK NY
10036-6945
US

V. Phone/Fax

Practice location:
  • Phone: 917-796-3256
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number018136
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: