Healthcare Provider Details

I. General information

NPI: 1639893290
Provider Name (Legal Business Name): KIMBERLY CUYCO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2022
Last Update Date: 09/28/2022
Certification Date: 09/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 W 55TH ST STE 205
NEW YORK NY
10019-4902
US

IV. Provider business mailing address

24711 UNION TPKE UNIT B
BELLEROSE NY
11426-1846
US

V. Phone/Fax

Practice location:
  • Phone: 212-759-8899
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number049329-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: