Provider Demographics
NPI:1518112283
Name:ARCENO, MERNADITA ARCEGA (PT)
Entity Type:Individual
Prefix:
First Name:MERNADITA
Middle Name:ARCEGA
Last Name:ARCENO
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 1:1606 CYPRESS LN
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5261
Mailing Address - Country:US
Mailing Address - Phone:732-715-1221
Mailing Address - Fax:
Practice Address - Street 1:1606 CYPRESS LN
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5261
Practice Address - Country:US
Practice Address - Phone:732-715-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-23
Last Update Date:2008-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist