Provider Demographics
NPI:1942604749
Name:UNGER, YITZCHOK (PT, DPT)
Entity Type:Individual
Prefix:
First Name:YITZCHOK
Middle Name:
Last Name:UNGER
Suffix:
Gender:M
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 1:195 BENNETT AVE
Mailing Address - Street 2:APT 2H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-4003
Mailing Address - Country:US
Mailing Address - Phone:347-683-0798
Mailing Address - Fax:
Practice Address - Street 1:195 BENNETT AVE
Practice Address - Street 2:APT 2H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-4003
Practice Address - Country:US
Practice Address - Phone:347-683-0798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-22
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038690-1225100000X
NYP95134225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP95134OtherLICENSE#
NY038690-1OtherLICENS#