Provider Demographics
NPI:1649592403
Name:GERMONES, ORESTES (PT)
Entity Type:Individual
Prefix:
First Name:ORESTES
Middle Name:
Last Name:GERMONES
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 1:5216 VAN LOON ST
Mailing Address - Street 2:APT 2A
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4267
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5216 VAN LOON ST
Practice Address - Street 2:APT 2A
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4267
Practice Address - Country:US
Practice Address - Phone:347-605-1467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist