Provider Demographics
NPI:1346472073
Name:URISAKA, MIHO (DPT)
Entity type:Individual
Prefix:DR
First Name:MIHO
Middle Name:
Last Name:URISAKA
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 1:315 MADISON AVE FL 17
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5419
Mailing Address - Country:US
Mailing Address - Phone:917-470-1130
Mailing Address - Fax:212-808-5510
Practice Address - Street 1:315 MADISON AVE FL 17
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5419
Practice Address - Country:US
Practice Address - Phone:917-470-1130
Practice Address - Fax:212-808-5510
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-13
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031717225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist