Provider Demographics
NPI:1578286134
Name:SUAREZ, JOSEPH JEROME ROBLES (PT)
Entity Type:Individual
Prefix:
First Name:JOSEPH JEROME
Middle Name:ROBLES
Last Name:SUAREZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 WILLIAMSBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1602
Mailing Address - Country:US
Mailing Address - Phone:718-823-3900
Mailing Address - Fax:718-823-3961
Practice Address - Street 1:2118 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1602
Practice Address - Country:US
Practice Address - Phone:718-823-3900
Practice Address - Fax:718-823-3961
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-20
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047100208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty