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NPI Code Detail

MEDICARE: MS. GEORGINA BUENAVENTURA LERMA RPT

MEDICARE: MS. GEORGINA BUENAVENTURA LERMA RPT
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 Therapist025892-1NY
2225100000XPhysical Therapist40QA01089100NJ

General Provider Information

NPI Number : 1881646222
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GEORGINA BUENAVENTURA LERMA RPT
Provider Business Mailing Address
First Line : 1910 SOUTH RD
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12601-6027
Country : US
Telephone Number : 845-454-0120
Fax Number : 845-454-6080
Provider Business Practice Location Address
First Line : 1910 SOUTH RD
Second Line :
City : POUGHKEEPSIE
State : NY
Zip : 12601-6027
Country : US
Telephone Number : 845-454-0120
Fax Number : 845-454-6080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2006
Last Update Date : 03/28/2013

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