MEDICARE: KRISTINE SCALA PT

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
1	225100000X	Physical Therapist	017875	NY

General Provider Information

NPI Number	:	1275506354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE SCALA PT

Provider Business Mailing Address
First Line	:	1160 MONTAUK HWY
Second Line	:
City	:	COPIAGUE
State	:	NY
Zip	:	11726
Country	:	US
Telephone Number	:	631-842-4606
Fax Number	:	631-842-0803

Provider Business Practice Location Address
First Line	:	475 NORTHERN BLVD STE 11
Second Line	:
City	:	GREAT NECK
State	:	NY
Zip	:	11021-4802
Country	:	US
Telephone Number	:	516-829-0030
Fax Number	:	516-466-7723

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	10/18/2024

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Directions to “ KRISTINE SCALA PT” Practice Location

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