Provider Demographics
NPI:1326166182
Name:ISHIGAMI, SHINOBU (PT)
Entity Type:Individual
Prefix:MS
First Name:SHINOBU
Middle Name:
Last Name:ISHIGAMI
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 1:5900 ARLINGTON AVE APT 3L
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1305
Mailing Address - Country:US
Mailing Address - Phone:718-548-8819
Mailing Address - Fax:
Practice Address - Street 1:180 FORT WASHINGTON AVE
Practice Address - Street 2:HARKNESS PAVILION RM. 170
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3735
Practice Address - Country:US
Practice Address - Phone:212-305-8432
Practice Address - Fax:212-342-5708
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018735225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist