Healthcare Provider Details

I. General information

NPI: 1578075446
Provider Name (Legal Business Name): ALEKSANDRA M KUTA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2017
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4823
US

IV. Provider business mailing address

535 E 70TH ST
NEW YORK NY
10021-4823
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1000
  • Fax:
Mailing address:
  • Phone: 212-606-1000
  • Fax: 212-379-2123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number036936
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: