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General NPI Number Information
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NPI Number | 1740516244
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Entity Type | Individual
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Provider Name | JADWIDA KUTYLA PT
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Gender | Female
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 450 7TH AVE SUITE 302
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City | NEW YORK
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State | NY
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Zip | 10123-0101
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Country | US
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Telephone | 212-594-6054
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Fax | 212-594-5915
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Provider Business Mailing Address
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Address Line | 450 7TH AVE SUITE 302
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City | NEW YORK
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State | NY
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Zip | 10123-0101
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Country | US
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Telephone | 212-594-6054
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Fax | 212-594-5915
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 015905-1
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License Number State | NY
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