Provider Demographics
NPI:1407178148
Name:ARCENA, HENRY DACUYON
Entity Type:Individual
Prefix:MR
First Name:HENRY
Middle Name:DACUYON
Last Name:ARCENA
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:HENRY
Other - Middle Name:DACUYON
Other - Last Name:ARCENA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:14 HOLLY ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305-4837
Mailing Address - Country:US
Mailing Address - Phone:201-779-6799
Mailing Address - Fax:
Practice Address - Street 1:14 HOLLY ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07305-4837
Practice Address - Country:US
Practice Address - Phone:201-779-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40PTQA0873300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist