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General NPI Number Information
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NPI Number | 1851464424
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Entity Type | Individual
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Provider Name | KRISTA L FAY PT, DPT, MCMT
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Gender | Female
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 03/24/2011
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Provider Practice Location Address
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Address Line | 136 E 57TH ST SUITE #705
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City | NEW YORK
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State | NY
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Zip | 10022-2707
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Country | US
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Telephone | 212-207-3177
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Fax | 212-207-2877
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Provider Business Mailing Address
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Address Line | 317 BREWERY RD
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City | WEST NYACK
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State | NY
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Zip | 10994-1214
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Country | US
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Telephone | 845-406-0304
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Fax | 212-207-3877
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 027446-1
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License Number State | NY
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