Provider Demographics
NPI:1316738917
Name:JUSTINIANO, KALEENA (DPT)
Entity type:Individual
Prefix:
First Name:KALEENA
Middle Name:
Last Name:JUSTINIANO
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 1:1613 RADCLIFF AVE APT 3B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4036
Mailing Address - Country:US
Mailing Address - Phone:347-245-6967
Mailing Address - Fax:
Practice Address - Street 1:6 GREENWICH OFFICE PARK
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5115
Practice Address - Country:US
Practice Address - Phone:203-869-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist