Provider Demographics
NPI:1376837765
Name:DE LEON, ROSE ANNE T (PT)
Entity Type:Individual
Prefix:
First Name:ROSE ANNE
Middle Name:T
Last Name:DE LEON
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 1:13338 41ST RD
Mailing Address - Street 2:SUITE CS8
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3782
Mailing Address - Country:US
Mailing Address - Phone:718-321-0886
Mailing Address - Fax:516-740-0781
Practice Address - Street 1:13338 41ST RD
Practice Address - Street 2:SUITE CS8
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3782
Practice Address - Country:US
Practice Address - Phone:718-321-0886
Practice Address - Fax:516-740-0781
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY032482225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist