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NPI Code Detail

MEDICARE: MARIA GIANELLI SARIQUE MOJICA

MEDICARE: MARIA GIANELLI SARIQUE MOJICA
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 Therapist041730NY

General Provider Information

NPI Number : 1639715956
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA GIANELLI SARIQUE MOJICA
Provider Business Mailing Address
First Line : 1963 GRAND CONCOURSE FL 2
Second Line :
City : BRONX
State : NY
Zip : 10453-4995
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1963 GRAND CONCOURSE FL 2
Second Line :
City : BRONX
State : NY
Zip : 10453-4995
Country : US
Telephone Number : 718-466-4600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2019
Last Update Date : 11/21/2019

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Directions to “ MARIA GIANELLI SARIQUE MOJICA ” Practice Location

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