Provider Demographics
NPI:1043521396
Name:HUTMAN, NATALLIA (DPT)
Entity type:Individual
Prefix:MS
First Name:NATALLIA
Middle Name:
Last Name:HUTMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 RICHMOND AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3912
Mailing Address - Country:US
Mailing Address - Phone:718-880-8571
Mailing Address - Fax:718-556-7868
Practice Address - Street 1:1855 RICHMOND AVE STE 104
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3912
Practice Address - Country:US
Practice Address - Phone:718-880-8571
Practice Address - Fax:718-556-7868
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19068225100000X
NY035024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist