Provider Demographics
NPI:1578796116
Name:KRESZ, DEBORAH (PT)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:KRESZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6935 MANSE ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5849
Mailing Address - Country:US
Mailing Address - Phone:718-268-2312
Mailing Address - Fax:718-268-2312
Practice Address - Street 1:9745 QUEENS BLVD STE 900
Practice Address - Street 2:THERACARE
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2108
Practice Address - Country:US
Practice Address - Phone:716-830-9274
Practice Address - Fax:718-830-9276
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004681-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics