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NPI Code Detail

MEDICARE: KAELYN RAGONESE PT, DPT

MEDICARE: KAELYN RAGONESE PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist045924NY

General Provider Information

NPI Number : 1124645155
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAELYN RAGONESE PT, DPT
Provider Business Mailing Address
First Line : 465 COLUMBUS AVE STE 130
Second Line :
City : VALHALLA
State : NY
Zip : 10595-1376
Country : US
Telephone Number : 914-741-2850
Fax Number : 914-741-2851
Provider Business Practice Location Address
First Line : 465 COLUMBUS AVE STE 130
Second Line :
City : VALHALLA
State : NY
Zip : 10595-1376
Country : US
Telephone Number : 914-741-2850
Fax Number : 914-741-2851
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2020
Last Update Date : 07/30/2020

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