IndividualActive
Kevin Yudianto, CTRS
NPI 1720790793 · Recreation Therapist · Jamaica, NY
Provider details
- NPI number
- 1720790793
- Entity type
- Individual
- Primary specialty
- Recreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- CTRS
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
17900 Linden Blvd Rm 219a
Jamaica, NY 11425-0001
Phone: (718) 526-1000
Approximate (ZIP-level) locationGet directions
Mailing address
17900 Linden Blvd Rm 219a
Jamaica, NY 11425-0001
Registry dates
- Enumerated
- 2022-12-21
- Last updated
- 2022-12-21
- Certified
- 2022-12-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.