Provider Demographics
NPI:1730857384
Name:PSATHAS, KADARRA ANGELICA
Entity type:Individual
Prefix:DR
First Name:KADARRA
Middle Name:ANGELICA
Last Name:PSATHAS
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:PO BOX 7672
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11520-0760
Mailing Address - Country:US
Mailing Address - Phone:516-205-9752
Mailing Address - Fax:
Practice Address - Street 1:4080 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5604
Practice Address - Country:US
Practice Address - Phone:516-862-3358
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist