Provider Demographics
NPI:1760795009
Name:MONEVA, ANNA MARIE ABELLA (PT)
Entity Type:Individual
Prefix:
First Name:ANNA MARIE
Middle Name:ABELLA
Last Name:MONEVA
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 1:4606 88TH ST
Mailing Address - Street 2:APT. 3E
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-3643
Mailing Address - Country:US
Mailing Address - Phone:646-596-6793
Mailing Address - Fax:
Practice Address - Street 1:4606 88TH ST
Practice Address - Street 2:APT. 3E
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-3643
Practice Address - Country:US
Practice Address - Phone:646-596-6793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029196225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist