Healthcare Provider Details

I. General information

NPI: 1306773668
Provider Name (Legal Business Name): IWONA KRASINKA PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 FOREST AVE
STATEN ISLAND NY
10302-2049
US

IV. Provider business mailing address

386 CROMWELL AVE
STATEN ISLAND NY
10305-2325
US

V. Phone/Fax

Practice location:
  • Phone: 718-390-0060
  • Fax:
Mailing address:
  • Phone: 917-774-8446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number007028
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: