Provider Demographics
NPI:1942360169
Name:GO-EBORA, ESTHER ROWENA (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:ESTHER ROWENA
Middle Name:
Last Name:GO-EBORA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2340 KINGSLAND AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6310
Mailing Address - Country:US
Mailing Address - Phone:718-325-7560
Mailing Address - Fax:
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:BLDG 1 2N10
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-5679
Practice Address - Fax:718-918-7578
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024053225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist