Provider Demographics
NPI:1750469755
Name:SCIASCIA, KRYSTAL (PT)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:SCIASCIA
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 1:1255 5TH AVE
Mailing Address - Street 2:SUITE 6L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3852
Mailing Address - Country:US
Mailing Address - Phone:914-400-1500
Mailing Address - Fax:914-478-8781
Practice Address - Street 1:375 DEER PARK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-2309
Practice Address - Country:US
Practice Address - Phone:631-321-6303
Practice Address - Fax:631-321-6317
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist