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General NPI Number Information
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NPI Number | 1962707307
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Entity Type | Individual
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Provider Name | KRISTINA M SMERAGULIO PT
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Gender | Female
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Dates
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Enumeration Date | 01/16/2011
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Last Update Date | 09/19/2014
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Provider Practice Location Address
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Address Line | 76-147 ROYAL POINCIANA DR
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City | KAILUA KONA
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State | HI
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Zip | 96740-2385
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Country | US
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Telephone | 808-327-6202
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Fax |
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Provider Business Mailing Address
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Address Line | 1170 BULL HILL RD
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City | GILBOA
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State | NY
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Zip | 12076-3638
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Country | US
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Telephone | 518-827-7098
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 008895
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License Number State | CT
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