Provider Demographics
NPI:1881012359
Name:DUTT, URMILA
Entity Type:Individual
Prefix:
First Name:URMILA
Middle Name:
Last Name:DUTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 2ND AVE
Mailing Address - Street 2:SUITE 802
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-4709
Mailing Address - Country:US
Mailing Address - Phone:212-600-9299
Mailing Address - Fax:718-775-3419
Practice Address - Street 1:800 2ND AVE
Practice Address - Street 2:SUITE 802
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-4709
Practice Address - Country:US
Practice Address - Phone:212-600-9299
Practice Address - Fax:718-775-3419
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035198-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist