Provider Demographics
NPI:1679249130
Name:COYOY, LEONORA BEYDEN (PHYSICAL THERAPY)
Entity Type:Individual
Prefix:
First Name:LEONORA
Middle Name:BEYDEN
Last Name:COYOY
Suffix:
Gender:F
Credentials:PHYSICAL THERAPY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1134 PEWTER CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1774
Mailing Address - Country:US
Mailing Address - Phone:301-200-2695
Mailing Address - Fax:
Practice Address - Street 1:1134 PEWTER CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1774
Practice Address - Country:US
Practice Address - Phone:301-200-2695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25468225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist