Provider Demographics
NPI:1235373507
Name:LUNGAY, JANICE LACHICA (PT)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:LACHICA
Last Name:LUNGAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5461 82ND ST
Mailing Address - Street 2:BASEMENT
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4719
Mailing Address - Country:US
Mailing Address - Phone:917-345-6643
Mailing Address - Fax:347-905-9841
Practice Address - Street 1:5461 82ND ST
Practice Address - Street 2:BASEMENT
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4719
Practice Address - Country:US
Practice Address - Phone:917-345-6643
Practice Address - Fax:347-905-9841
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026998225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist