Provider Demographics
NPI:1437664224
Name:JAPOS, MARIA ANGELICA FAYLOGA
Entity Type:Individual
Prefix:
First Name:MARIA ANGELICA
Middle Name:FAYLOGA
Last Name:JAPOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15-17 WILLETS ST
Mailing Address - Street 2:1G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002
Mailing Address - Country:US
Mailing Address - Phone:929-219-7490
Mailing Address - Fax:
Practice Address - Street 1:1072 HAVEMEYER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5310
Practice Address - Country:US
Practice Address - Phone:718-863-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-03
Last Update Date:2017-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040145225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist