Healthcare Provider Details

I. General information

NPI: 1841128352
Provider Name (Legal Business Name): ANGELIZA DELA MERCED ARCIAGA PR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4265 KISSENA BLVD
FLUSHING NY
11355
US

IV. Provider business mailing address

5125 VAN KLEECK ST APT 2C
ELMHURST NY
11373
US

V. Phone/Fax

Practice location:
  • Phone: 718-461-1365
  • Fax:
Mailing address:
  • Phone: 347-599-3789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0055321
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: