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General NPI Number Information
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NPI Number | 1891908778
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Entity Type | Individual
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Provider Name | LUBA L. STAROSTIAK P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 06/19/2013
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Provider Practice Location Address
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Address Line | 974 ROUTE 45 SUITE 1100
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City | POMONA
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State | NY
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Zip | 10970-3520
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Country | US
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Telephone | 845-517-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 667 SOUTH MOUNTAIN ROAD
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City | NEW CITY
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State | NY
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Zip | 10956
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Country | US
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Telephone |
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Fax |
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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 | 012548-1
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License Number State | NY
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