Provider Demographics
NPI:1649218330
Name:SALVANERA, ROWENA (PT)
Entity Type:Individual
Prefix:MS
First Name:ROWENA
Middle Name:
Last Name:SALVANERA
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 1:200 W 58TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1432
Mailing Address - Country:US
Mailing Address - Phone:212-307-1151
Mailing Address - Fax:212-307-0759
Practice Address - Street 1:6860 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4220
Practice Address - Country:US
Practice Address - Phone:718-896-4100
Practice Address - Fax:718-896-7760
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ33C51Medicare ID - Type UnspecifiedEMPIRE MEDICARE