Provider Demographics
NPI:1194021709
Name:BARGAMENTO, ALMA CONCEPCION (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:ALMA
Middle Name:CONCEPCION
Last Name:BARGAMENTO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:19 GROVE STREET
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07403-1607
Mailing Address - Country:US
Mailing Address - Phone:973-626-1777
Mailing Address - Fax:
Practice Address - Street 1:465 GRAND STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002
Practice Address - Country:US
Practice Address - Phone:212-420-1999
Practice Address - Fax:212-420-1910
Is Sole Proprietor?:No
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022536-1225100000X
NJ40QA01155000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist