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General NPI Number Information
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NPI Number | 1538480421
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Entity Type | Individual
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Provider Name | JONATHAN CATANGAY LAQUI DPT
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Gender | Male
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 107 E BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10002-7006
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Country | US
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Telephone | 212-233-0889
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Fax |
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Provider Business Mailing Address
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Address Line | 997 ROSS ST
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City | RAHWAY
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State | NJ
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Zip | 07065-2151
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Country | US
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Telephone | 201-660-0968
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 031237
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License Number State | NY
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