Provider Demographics
NPI:1558309385
Name:WILLEKES, KAIA (DPT)
Entity Type:Individual
Prefix:
First Name:KAIA
Middle Name:
Last Name:WILLEKES
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 1:67 SAINT PAULS PL
Mailing Address - Street 2:SUITE B-7
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-1674
Mailing Address - Country:US
Mailing Address - Phone:212-330-9040
Mailing Address - Fax:718-450-3981
Practice Address - Street 1:67 SAINT PAULS PL
Practice Address - Street 2:SUITE B-7
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-1674
Practice Address - Country:US
Practice Address - Phone:212-330-9040
Practice Address - Fax:718-450-3981
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028181225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist