Provider Demographics
NPI:1346494929
Name:PADILLA, MIGDALIA MARIA (PT)
Entity Type:Individual
Prefix:MS
First Name:MIGDALIA
Middle Name:MARIA
Last Name:PADILLA
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 1:3441 85TH ST APT 2P
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3204
Mailing Address - Country:US
Mailing Address - Phone:917-304-1995
Mailing Address - Fax:
Practice Address - Street 1:3441 85TH ST APT 2P
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-3204
Practice Address - Country:US
Practice Address - Phone:917-304-1995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY22499-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist