Provider Demographics
NPI:1508107624
Name:KUTIN-BOATENG, AMA (DPT)
Entity Type:Individual
Prefix:
First Name:AMA
Middle Name:
Last Name:KUTIN-BOATENG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-2001
Mailing Address - Country:US
Mailing Address - Phone:914-333-7000
Mailing Address - Fax:
Practice Address - Street 1:15 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-2001
Practice Address - Country:US
Practice Address - Phone:914-333-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist