Provider Demographics
NPI:1578454252
Name:KUGEL, EVAN (DPT)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:KUGEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 NY-17 #19
Mailing Address - Street 2:
Mailing Address - City:TUXEDO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:10987
Mailing Address - Country:US
Mailing Address - Phone:845-671-0571
Mailing Address - Fax:
Practice Address - Street 1:259 WOODLANDS DR
Practice Address - Street 2:
Practice Address - City:TUXEDO PARK
Practice Address - State:NY
Practice Address - Zip Code:10987-4819
Practice Address - Country:US
Practice Address - Phone:845-671-0571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NY050817225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist