Provider Demographics
NPI:1760591465
Name:ANDRES, LEE-ZEL MAY CARINGAL (RPT)
Entity Type:Individual
Prefix:
First Name:LEE-ZEL MAY
Middle Name:CARINGAL
Last Name:ANDRES
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1443 28TH AVE APT 2D
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3663
Mailing Address - Country:US
Mailing Address - Phone:917-783-8616
Mailing Address - Fax:347-732-9011
Practice Address - Street 1:7922 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-1801
Practice Address - Country:US
Practice Address - Phone:347-494-5684
Practice Address - Fax:347-494-5641
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02837832Medicaid
NY02837832Medicaid