Provider Demographics
NPI:1093779233
Name:NKUNZI, NKINZO M (DRPT)
Entity Type:Individual
Prefix:DR
First Name:NKINZO
Middle Name:M
Last Name:NKUNZI
Suffix:
Gender:M
Credentials:DRPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 9TH ST, UNIT 1
Mailing Address - Street 2:#341 PMB NISKY CENTER
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-6111
Mailing Address - Country:US
Mailing Address - Phone:340-776-0899
Mailing Address - Fax:
Practice Address - Street 1:1902 9TH ST, UNIT 1
Practice Address - Street 2:#341 PMB NISKY CENTER
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-6111
Practice Address - Country:US
Practice Address - Phone:340-776-0899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI712251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics