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NPI Code Detail

MEDICARE: MRS. CATHERINE TABACO ESCOBILLO-GARCES PT

MEDICARE: MRS. CATHERINE TABACO ESCOBILLO-GARCES 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 Therapist028863NY

General Provider Information

NPI Number : 1790969939
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CATHERINE TABACO ESCOBILLO-GARCES PT
Provider Business Mailing Address
First Line : 8830 51ST AVE APT 5A
Second Line :
City : ELMHURST
State : NY
Zip : 11373-5549
Country : US
Telephone Number : 347-320-2767
Fax Number :
Provider Business Practice Location Address
First Line : 3602 14TH ST
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11106-4704
Country : US
Telephone Number : 718-392-2510
Fax Number : 718-392-2637
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/24/2007
Last Update Date : 07/18/2012

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