Healthcare Provider Details

I. General information

NPI: 1841403938
Provider Name (Legal Business Name): EMMYLOU BRIONES CUEVAS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150-12 14TH AVENUE
WHITESTONE NY
11357
US

IV. Provider business mailing address

2128 HAIGHT AVENUE APT. 2
BRONX NY
10461
US

V. Phone/Fax

Practice location:
  • Phone: 718-746-8757
  • Fax: 718-746-3069
Mailing address:
  • Phone: 646-267-7598
  • Fax: 718-944-6266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number025549
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: