| Doctor Name: | MR. SAMKUTTY CYRIAC |
| NPI Number: | 1104877422 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 027084 |
| Business Practice Address: | 226 Doherty Ave Elmont, NY - 110033016 |
| Business Phone Number: | 9175601734 |
| Business Fax Number: | 5162165045 |
| Mailing Address: | 1039 N 5th St, NEW HYDE PARK |
| State: | NY |
| Postal Code: | 110402939 |
| Phone Number: | 9175601734 |
| Fax Number: | 5163520350 |
| NPI Enumeration Date: | 05/12/2006 |
| NPI Last Update Date: | 03/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 027084 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |