Provider Demographics
NPI:1427927524
Name:KURKUL, ALYSSA GABRIELA
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:GABRIELA
Last Name:KURKUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13071 MARINER DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-5975
Mailing Address - Country:US
Mailing Address - Phone:330-461-1735
Mailing Address - Fax:
Practice Address - Street 1:30 ROTHROCK LOOP
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1331
Practice Address - Country:US
Practice Address - Phone:330-666-2228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT0208892251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics