MEDICARE: ARIANE CAMILLE LAJATO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	051620-01	NY

General Provider Information

NPI Number	:	1215774120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANE CAMILLE LAJATO

Provider Business Mailing Address
First Line	:	9430 54TH AVE
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-4614
Country	:	US
Telephone Number	:	510-753-4025
Fax Number	:

Provider Business Practice Location Address
First Line	:	4046 75TH ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1012
Country	:	US
Telephone Number	:	929-329-6775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	07/09/2024

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Directions to “ ARIANE CAMILLE LAJATO ” Practice Location

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