Provider Demographics
NPI:1619257276
Name:ESTRELLA, JENNIFER AGUILOS (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AGUILOS
Last Name:ESTRELLA
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 1:185 CANAL ST STE 505
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4537
Mailing Address - Country:US
Mailing Address - Phone:212-966-3040
Mailing Address - Fax:212-966-2944
Practice Address - Street 1:185 CANAL ST STE 505
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4537
Practice Address - Country:US
Practice Address - Phone:212-966-3040
Practice Address - Fax:212-966-2944
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029434225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist