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NPI Code Detail

MEDICARE: MR. EMMANUEL BANCAT SUAZO PHYSICAL THERAPIST

MEDICARE:  MR. EMMANUEL BANCAT SUAZO  PHYSICAL THERAPIST
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
1225100000XPhysical Therapist022921NY

General Provider Information

NPI Number : 1346464336
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. EMMANUEL BANCAT SUAZO PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 2720 COLONIAL DR
Second Line :
City : NEW WINDSOR
State : NY
Zip : 12553-4926
Country : US
Telephone Number : 845-567-1787
Fax Number :
Provider Business Practice Location Address
First Line : 3435 DEKALB AVE
Second Line :
City : BRONX
State : NY
Zip : 10467-2301
Country : US
Telephone Number : 718-547-8899
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 07/08/2007

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Directions to “ MR. EMMANUEL BANCAT SUAZO PHYSICAL THERAPIST” Practice Location

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