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General NPI Number Information
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NPI Number | 1992516819
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Entity Type | Individual
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Provider Name | DIEGO ALEJANDRO PAYUMO IMPERIO PT
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Gender | Male
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 651 W 180TH ST
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City | NEW YORK
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State | NY
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Zip | 10033-4802
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Country | US
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Telephone | 646-918-7816
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Fax |
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Provider Business Mailing Address
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Address Line | 6770 YELLOWSTONE BLVD APT 4R
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City | FOREST HILLS
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State | NY
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Zip | 11375-2838
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Country | US
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Telephone | 908-476-8007
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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 | 052030
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License Number State | NY
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