Provider Demographics
NPI:1710450861
Name:KURINETS, ADELINA ROBERTOVNA (PT)
Entity Type:Individual
Prefix:
First Name:ADELINA
Middle Name:ROBERTOVNA
Last Name:KURINETS
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 1:2781 SHELL RD STE 101
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6142
Mailing Address - Country:US
Mailing Address - Phone:718-648-1234
Mailing Address - Fax:
Practice Address - Street 1:2781 SHELL RD # 101
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6142
Practice Address - Country:US
Practice Address - Phone:718-648-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043758225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist