Individual
ED KAST III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., P.T.
Contact information
Practice address
21 PEEKSKILL HOLLOW RD STE 201, PUTNAM VALLEY, NY 10579-3254
(845) 528-3133
(845) 528-0463
Mailing address
4 WINCHESTER AVE, PEEKSKILL, NY 10566-6800
(914) 737-2739
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
0113771
NY
Other
Enumeration date
02/16/2007
Last updated
07/08/2007
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