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NPI Code Detail

MEDICARE: JOMAH SISON LUMAGUI DPT

MEDICARE: JOMAH SISON LUMAGUI DPT
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 Therapist032089NY

General Provider Information

NPI Number : 1780997353
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOMAH SISON LUMAGUI DPT
Provider Business Mailing Address
First Line : 4237 JUDGE ST
Second Line :
City : ELMHURST
State : NY
Zip : 11373-2554
Country : US
Telephone Number : 718-406-7689
Fax Number : 718-446-1984
Provider Business Practice Location Address
First Line : 3744 75TH ST BSMT
Second Line :
City : JACKSON HEIGHTS
State : NY
Zip : 11372-6444
Country : US
Telephone Number : 718-446-0437
Fax Number : 718-446-1984
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2010
Last Update Date : 09/23/2020

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