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NPI Code Detail

MEDICARE: APOLONIO AGUILERA PRINCIPE JR. PT

MEDICARE:   APOLONIO AGUILERA PRINCIPE JR. PT
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 Therapist024321NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1024321-1OTHERNYNY LICENSE

General Provider Information

NPI Number : 1386670925
Entity Type Code : Individual
Provider Name (Legal Business Name) : APOLONIO AGUILERA PRINCIPE JR. PT
Provider Business Mailing Address
First Line : 26 FIREMENS MEMORIAL DR
Second Line : SUITE 115
City : POMONA
State : NY
Zip : 10970-3553
Country : US
Telephone Number : 800-750-8616
Fax Number : 845-362-8400
Provider Business Practice Location Address
First Line : 1075 CENTRAL PARK AVE
Second Line :
City : SCARSDALE
State : NY
Zip : 10583-3242
Country : US
Telephone Number : 800-750-8616
Fax Number : 845-362-8474
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2006
Last Update Date : 03/26/2015

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Directions to “ APOLONIO AGUILERA PRINCIPE JR. PT” Practice Location

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