Provider Demographics
NPI:1629222690
Name:CALBITAZA, RODOLFO (PT)
Entity Type:Individual
Prefix:MR
First Name:RODOLFO
Middle Name:
Last Name:CALBITAZA
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 1:34 E 208TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2719
Mailing Address - Country:US
Mailing Address - Phone:718-515-0218
Mailing Address - Fax:
Practice Address - Street 1:34 E 208TH ST
Practice Address - Street 2:#1A
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2719
Practice Address - Country:US
Practice Address - Phone:718-515-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017713-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist