Provider Demographics
NPI:1699007054
Name:LINAO, RHODORA BAJAO
Entity Type:Individual
Prefix:
First Name:RHODORA
Middle Name:BAJAO
Last Name:LINAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 94TH ST
Mailing Address - Street 2:FLR 2
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2840
Mailing Address - Country:US
Mailing Address - Phone:347-784-5308
Mailing Address - Fax:
Practice Address - Street 1:199 COMMUNITY DR
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5502
Practice Address - Country:US
Practice Address - Phone:516-365-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007230225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant