Provider Demographics
NPI:1740747955
Name:PADIOS, MAICA TUAZON (PT)
Entity Type:Individual
Prefix:
First Name:MAICA
Middle Name:TUAZON
Last Name:PADIOS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8730 204TH ST APT A32
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-1535
Mailing Address - Country:US
Mailing Address - Phone:917-650-9934
Mailing Address - Fax:
Practice Address - Street 1:7 W 45TH ST FL 9
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4905
Practice Address - Country:US
Practice Address - Phone:646-760-1782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-23
Last Update Date:2019-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044149225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist