Provider Demographics
NPI:1629012257
Name:ARRIESGADO, MINELEE CONDOR (PT)
Entity Type:Individual
Prefix:MS
First Name:MINELEE
Middle Name:CONDOR
Last Name:ARRIESGADO
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 1:241 EGBERT AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2646
Mailing Address - Country:US
Mailing Address - Phone:718-876-6956
Mailing Address - Fax:718-876-6956
Practice Address - Street 1:ROCKWELL MEDICAL SERVICES 139 FULTON ST
Practice Address - Street 2:SUITE 700
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038
Practice Address - Country:US
Practice Address - Phone:212-406-0127
Practice Address - Fax:212-732-9761
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026753-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ30G41Medicare ID - Type Unspecified