Provider Demographics
NPI:1528218690
Name:POLICARPIO, ANALENE (PT)
Entity Type:Individual
Prefix:
First Name:ANALENE
Middle Name:
Last Name:POLICARPIO
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 1:5238 83RD ST
Mailing Address - Street 2:APT 3
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4722
Mailing Address - Country:US
Mailing Address - Phone:732-447-8937
Mailing Address - Fax:
Practice Address - Street 1:5238 83RD ST APT 3
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4722
Practice Address - Country:US
Practice Address - Phone:732-447-8937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026643225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist