Provider Demographics
NPI:1649752221
Name:PARAGAS, EMELITA D (PT)
Entity Type:Individual
Prefix:MRS
First Name:EMELITA
Middle Name:D
Last Name:PARAGAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA EMELITA
Other - Middle Name:D
Other - Last Name:PARAGAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:15-01 BROADWAY
Mailing Address - Street 2:SUITE 30A
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410
Mailing Address - Country:US
Mailing Address - Phone:201-703-7107
Mailing Address - Fax:201-703-0135
Practice Address - Street 1:15-01 BROADWAY
Practice Address - Street 2:SUITE 30A
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410
Practice Address - Country:US
Practice Address - Phone:201-703-7107
Practice Address - Fax:201-703-0135
Is Sole Proprietor?:No
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00464200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist