Provider Demographics
NPI:1891030045
Name:NERI-ROLON, CLAUDIA R (PT)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:R
Last Name:NERI-ROLON
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 1:2448 33RD ST
Mailing Address - Street 2:APT 3F
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-1181
Mailing Address - Country:US
Mailing Address - Phone:407-413-0601
Mailing Address - Fax:
Practice Address - Street 1:120 BENNETT AVE
Practice Address - Street 2:#6L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033
Practice Address - Country:US
Practice Address - Phone:212-682-8727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035539-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist