Provider Demographics
NPI:1851660120
Name:CLORIBEL, ANNA LEA FANGON (PT, BPT)
Entity Type:Individual
Prefix:
First Name:ANNA LEA
Middle Name:FANGON
Last Name:CLORIBEL
Suffix:
Gender:F
Credentials:PT, BPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 E 32ND ST
Mailing Address - Street 2:FL 8
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5557
Mailing Address - Country:US
Mailing Address - Phone:212-596-4360
Mailing Address - Fax:212-966-2378
Practice Address - Street 1:44 E 32ND ST
Practice Address - Street 2:FL 8
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5557
Practice Address - Country:US
Practice Address - Phone:212-596-4360
Practice Address - Fax:212-966-2378
Is Sole Proprietor?:No
Enumeration Date:2011-12-15
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY034546-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic