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NPI Code Detail

MEDICARE: RYAN KITZEN DPT

MEDICARE:   RYAN  KITZEN  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 Therapist028851NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11407997216OTHERNYNPI

General Provider Information

NPI Number : 1407997216
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN KITZEN DPT
Provider Business Mailing Address
First Line : 30 ANDREWS DRIVE
Second Line :
City : MANHASSETT
State : NY
Zip : 11030-2312
Country : US
Telephone Number : 212-759-2211
Fax Number :
Provider Business Practice Location Address
First Line : 120 E 56TH ST
Second Line : SUITE 1010
City : NEW YORK
State : NY
Zip : 10022-3607
Country : US
Telephone Number : 212-759-2211
Fax Number : 212-829-1189
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 10/01/2008

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