Provider Demographics
NPI:1255869160
Name:MOUNTEER, CAROLYN (PT, DPT, NCS)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:MOUNTEER
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E 82ND ST APT 1L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-5952
Mailing Address - Country:US
Mailing Address - Phone:518-331-4154
Mailing Address - Fax:
Practice Address - Street 1:420 E 82ND ST APT 1L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-5952
Practice Address - Country:US
Practice Address - Phone:518-331-4154
Practice Address - Fax:518-331-4154
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035336225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist