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NPI Code Detail

MEDICARE: JACQUEIDY ANTONIA ESPAILLAT

MEDICARE: JACQUEIDY ANTONIA ESPAILLAT
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
1225200000XPhysical Therapy Assistant011491NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528526563
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUEIDY ANTONIA ESPAILLAT
Provider Business Mailing Address
First Line : 2929 MICKLE AVE
Second Line :
City : BRONX
State : NY
Zip : 10469-3303
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2465 BATHGATE AVE
Second Line :
City : BRONX
State : NY
Zip : 10458-5928
Country : US
Telephone Number : 718-367-5917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2019
Last Update Date : 03/08/2019

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Directions to “ JACQUEIDY ANTONIA ESPAILLAT ” Practice Location

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