Kristin Ann Di Vico MSPT

NPI 1700076866 - Physical Therapist - 2251P0200X

NPI Details
NPI 1700076866
Gender Female
Enumeration Date 07/25/2007
Last Updated 07/25/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
3400 N SHELLEY ST
MOHEGAN LAKE NY, 10547-1441, US
Phone (914) 962-3458
Fax
Business Location
3400 N SHELLEY ST
MOHEGAN LAKE NY, 10547-1441, US
Phone (914) 962-3458
Fax
Toxanomy
Taxonomy Code 2251P0200X
License State New York
License Number PT 014 318-1
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According to our database, Kristin Ann Di Vico MSPT NPI is 1700076866, taxonomy code is 2251P0200X and license number is PT 014 318-1, license state is located at New York. Kristin Ann Di Vico MSPT physically located at 3400 N Shelley St, Mohegan Lake NY, 10547-1441. NPI Number Kristin Ann Di Vico MSPT has the Individual type.

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1700076866 NPI number is provided on an as is basis without warranty of any kind. 1700076866 is maintained by the National Plan & Provider Enumeration System. The contents of Kristin Ann Di Vico MSPT are for informational purposes only.