Healthcare Provider Details

I. General information

NPI: 1861795239
Provider Name (Legal Business Name): NATALIE DEE KINGHORN P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 12/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 8TH AVE SUITE 300
NEW YORK NY
10036-7000
US

IV. Provider business mailing address

780 8TH AVE SUITE 300
NEW YORK NY
10036-7000
US

V. Phone/Fax

Practice location:
  • Phone: 212-245-1841
  • Fax: 212-245-1937
Mailing address:
  • Phone: 212-245-1841
  • Fax: 212-245-1937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number026915
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: