Provider Demographics
NPI:1699359315
Name:BARRERA, JANEEN MARIE ENERLAN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:JANEEN MARIE
Middle Name:ENERLAN
Last Name:BARRERA
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2167 CRUGER AVE APT 4G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-1521
Mailing Address - Country:US
Mailing Address - Phone:929-371-2533
Mailing Address - Fax:
Practice Address - Street 1:1040 HAVEMEYER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5382
Practice Address - Country:US
Practice Address - Phone:929-371-2533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039096225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist