Provider Demographics
NPI:1578179446
Name:DRUMM, MICHAELLA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MICHAELLA
Middle Name:
Last Name:DRUMM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BRIDGE ST
Mailing Address - Street 2:STE 71
Mailing Address - City:IRVINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:10533-1560
Mailing Address - Country:US
Mailing Address - Phone:914-478-0608
Mailing Address - Fax:914-375-3402
Practice Address - Street 1:1995 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5882
Practice Address - Country:US
Practice Address - Phone:212-712-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist