1043766157 NPI number — ANDREA KALLIOPE STRASSMAN PT, DPT

Table of content: ANDREA KALLIOPE STRASSMAN PT, DPT (NPI 1043766157)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043766157 NPI number — ANDREA KALLIOPE STRASSMAN PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRASSMAN
Provider First Name:
ANDREA
Provider Middle Name:
KALLIOPE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TSIGAKOS
Provider Other First Name:
ANREA
Provider Other Middle Name:
KALLIOPE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043766157
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
719 GLEN RIDGE LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EAST NORTHPORT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11731
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-946-0208
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
300 GARDEN CITY PLZ
Provider Second Line Business Practice Location Address:
SUITE 350
Provider Business Practice Location Address City Name:
GARDEN CITY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11530-3302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-747-9030
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2251P0200X , with the licence number:  041050-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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