Provider Demographics
NPI:1609145366
Name:BARANGAN, VICTOR (BS)
Entity Type:Individual
Prefix:MR
First Name:VICTOR
Middle Name:
Last Name:BARANGAN
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 51ST RD
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7505
Mailing Address - Country:US
Mailing Address - Phone:917-373-1855
Mailing Address - Fax:
Practice Address - Street 1:6725 51ST RD
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-7505
Practice Address - Country:US
Practice Address - Phone:917-373-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013931-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist