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NPI Code Detail

MEDICARE: MS. ABIGAIL JOAN TINGZON GERONGAY PT

MEDICARE: MS. ABIGAIL JOAN TINGZON GERONGAY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist070018884IL

General Provider Information

NPI Number : 1699042119
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ABIGAIL JOAN TINGZON GERONGAY PT
Provider Business Mailing Address
First Line : 5838 N SHERIDAN RD
Second Line : GENESIS SHERIDAN SHORE
City : CHICAGO
State : IL
Zip : 60660-4916
Country : US
Telephone Number : 407-756-8744
Fax Number :
Provider Business Practice Location Address
First Line : 5838 N SHERIDAN RD
Second Line : GENESIS SHERIDAN SHORE
City : CHICAGO
State : IL
Zip : 60660-4916
Country : US
Telephone Number : 407-756-8744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2011
Last Update Date : 11/29/2011

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