Provider Demographics
NPI:1407161581
Name:CARREON, MARIA LEAH GIABIA (PT)
Entity Type:Individual
Prefix:
First Name:MARIA LEAH
Middle Name:GIABIA
Last Name:CARREON
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 1:74 WATERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE FERRY
Mailing Address - State:NJ
Mailing Address - Zip Code:07643-2207
Mailing Address - Country:US
Mailing Address - Phone:347-754-1346
Mailing Address - Fax:
Practice Address - Street 1:74 WATERSIDE DR
Practice Address - Street 2:
Practice Address - City:LITTLE FERRY
Practice Address - State:NJ
Practice Address - Zip Code:07643-2207
Practice Address - Country:US
Practice Address - Phone:347-754-1346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027100225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist