Provider Demographics
NPI:1386075984
Name:DUBENSKY, TRACEY (DPT)
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:DUBENSKY
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 1:301 E 22ND ST
Mailing Address - Street 2:APT #4F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4816
Mailing Address - Country:US
Mailing Address - Phone:917-374-8771
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVENUE
Practice Address - Street 2:BELLEVUE HOSPITAL CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016
Practice Address - Country:US
Practice Address - Phone:212-562-7059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-06
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037006-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist