Provider Demographics
NPI:1225673536
Name:ALCAYAGA CACERES, NATALIA ALEXANDRA (MSPT, PT)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:ALEXANDRA
Last Name:ALCAYAGA CACERES
Suffix:
Gender:F
Credentials:MSPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15818 RIVERSIDE DR W APT 5H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1031
Mailing Address - Country:US
Mailing Address - Phone:646-290-1300
Mailing Address - Fax:
Practice Address - Street 1:16 PARK PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-2504
Practice Address - Country:US
Practice Address - Phone:646-518-5558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-11
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044933-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist