Healthcare Provider Details

I. General information

NPI: 1205358025
Provider Name (Legal Business Name): BIG CITY PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3202 MORLEY AVE
STATEN ISLAND NY
10306-1906
US

IV. Provider business mailing address

3202 MORLEY AVE
STATEN ISLAND NY
10306-1906
US

V. Phone/Fax

Practice location:
  • Phone: 917-945-0805
  • Fax:
Mailing address:
  • Phone: 917-945-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number035024
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. NATALLIA HUTMAN
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 917-945-0805