Provider Demographics
NPI:1235388570
Name:BIHASA, MA THERESA CRUZATE (PT)
Entity Type:Individual
Prefix:
First Name:MA THERESA
Middle Name:CRUZATE
Last Name:BIHASA
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 1:31 TERRACE AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2914
Mailing Address - Country:US
Mailing Address - Phone:516-354-0514
Mailing Address - Fax:516-354-0514
Practice Address - Street 1:31 TERRACE AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2914
Practice Address - Country:US
Practice Address - Phone:516-354-0514
Practice Address - Fax:516-354-0514
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019187-1225100000X, 2251E1300X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical