Provider Demographics
NPI:1790005965
Name:CARTABIO, MARIA CORAZON (PT)
Entity Type:Individual
Prefix:
First Name:MARIA CORAZON
Middle Name:
Last Name:CARTABIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARIA CORAZON
Other - Middle Name:
Other - Last Name:CALMONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:8838 77TH STREET
Mailing Address - Street 2:APT A
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421
Mailing Address - Country:US
Mailing Address - Phone:917-601-0083
Mailing Address - Fax:
Practice Address - Street 1:14916 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4038
Practice Address - Country:US
Practice Address - Phone:718-291-3888
Practice Address - Fax:718-291-4888
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032155208100000X
NY032155-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation