=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760591465
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEE-ZEL MAY CARINGAL ANDRES RPT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/29/2006
-----------------------------------------------------
Last Update Date | 06/17/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7922 JAMAICA AVE
-----------------------------------------------------
City | WOODHAVEN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11421-1801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 347-494-5684
-----------------------------------------------------
Fax | 347-494-5641
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1443 28TH AVE APT 2D
-----------------------------------------------------
City | ASTORIA
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11102-3663
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-783-8616
-----------------------------------------------------
Fax | 347-732-9011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 025591
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------