Provider Demographics
NPI:1750314910
Name:DEGUZMAN, ALMA (LPT, CPED)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:
Last Name:DEGUZMAN
Suffix:
Gender:F
Credentials:LPT, CPED
Other - Prefix:
Other - First Name:ALMA
Other - Middle Name:
Other - Last Name:MALIGAYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPT, CPED
Mailing Address - Street 1:1620 US 1 HWY
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596-9219
Mailing Address - Country:US
Mailing Address - Phone:984-237-0096
Mailing Address - Fax:800-877-3496
Practice Address - Street 1:1620 US 1 HWY
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596-9219
Practice Address - Country:US
Practice Address - Phone:984-237-0096
Practice Address - Fax:800-877-3496
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070008449225100000X
NCP10385225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK25646Medicare PIN