Basic Information
Provider Information
NPI: 1861778466
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MATSUZAKI
FirstName: YUKIKO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100214898
CountryCode: US
TelephoneNumber: 2126061225
FaxNumber:  
Practice Location
Address1: 535 E 70TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 10021
CountryCode: US
TelephoneNumber: 2126061225
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/26/2011
LastUpdateDate: 04/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251X0800X034078NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic

No ID Information.


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