Provider Demographics
NPI:1700187903
Name:PALACOL DUCHATELIER, AMELITA (PT)
Entity Type:Individual
Prefix:MRS
First Name:AMELITA
Middle Name:
Last Name:PALACOL DUCHATELIER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:AMELITA
Other - Middle Name:MARINO
Other - Last Name:PALACOL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7525 153RD ST
Mailing Address - Street 2:APT. 139
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3090
Mailing Address - Country:US
Mailing Address - Phone:718-755-9411
Mailing Address - Fax:
Practice Address - Street 1:7525 153RD ST
Practice Address - Street 2:APT. 139
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3090
Practice Address - Country:US
Practice Address - Phone:718-755-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2014-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029546-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist