Provider Demographics
NPI:1235467796
Name:MAPESO, ANN ABIGAIL S (RPT)
Entity Type:Individual
Prefix:MS
First Name:ANN ABIGAIL
Middle Name:S
Last Name:MAPESO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 MORRIS PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1447
Mailing Address - Country:US
Mailing Address - Phone:718-239-2087
Mailing Address - Fax:718-239-2087
Practice Address - Street 1:1030 MORRIS PARK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1447
Practice Address - Country:US
Practice Address - Phone:718-239-2087
Practice Address - Fax:718-239-2087
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023749-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist