Provider Demographics
NPI:1174154637
Name:HOWLAND-KRUSE, BERT (PT)
Entity type:Individual
Prefix:MR
First Name:BERT
Middle Name:
Last Name:HOWLAND-KRUSE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 CORPORATE BLVD S
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-6862
Mailing Address - Country:US
Mailing Address - Phone:914-294-6289
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE BLVD S
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6862
Practice Address - Country:US
Practice Address - Phone:914-294-6289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist