Provider Demographics
NPI:1205015286
Name:ALUNAN, COLEEN BARBASA
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:BARBASA
Last Name:ALUNAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-4809
Mailing Address - Country:US
Mailing Address - Phone:718-399-6234
Mailing Address - Fax:718-399-3516
Practice Address - Street 1:468 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11205-4809
Practice Address - Country:US
Practice Address - Phone:718-399-6234
Practice Address - Fax:718-399-3516
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ1275WS861Medicare PIN