Provider Demographics
NPI:1356667661
Name:NORTON, ETHEL ABARQUEZ (PT)
Entity Type:Individual
Prefix:
First Name:ETHEL
Middle Name:ABARQUEZ
Last Name:NORTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ETHEL
Other - Middle Name:MONTANEZ
Other - Last Name:ABARQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3763 83RD ST
Mailing Address - Street 2:#312
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7146
Mailing Address - Country:US
Mailing Address - Phone:646-309-4492
Mailing Address - Fax:
Practice Address - Street 1:139 CENTRE ST
Practice Address - Street 2:#202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4552
Practice Address - Country:US
Practice Address - Phone:212-343-9398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-12
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0019348225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A400104269OtherMEDICARE