MEDICARE: MAICA TUAZON PADIOS 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
1	225100000X	Physical Therapist	044149	NY

General Provider Information

NPI Number	:	1740747955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAICA TUAZON PADIOS PT

Provider Business Mailing Address
First Line	:	8730 204TH ST APT A32
Second Line	:
City	:	HOLLIS
State	:	NY
Zip	:	11423-1535
Country	:	US
Telephone Number	:	917-650-9934
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 W 45TH ST FL 9
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10036-4905
Country	:	US
Telephone Number	:	646-760-1782
Fax Number	:

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

Provider Enumeration Date	:	02/23/2019
Last Update Date	:	02/23/2019

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Directions to “ MAICA TUAZON PADIOS PT” Practice Location

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