Provider Demographics
NPI:1972819241
Name:TOLENTINO, CHESTER JAY R (PT)
Entity Type:Individual
Prefix:
First Name:CHESTER JAY
Middle Name:R
Last Name:TOLENTINO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 52ND ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-4543
Mailing Address - Country:US
Mailing Address - Phone:718-255-6229
Mailing Address - Fax:718-255-1288
Practice Address - Street 1:4310 52ND ST
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4542
Practice Address - Country:US
Practice Address - Phone:718-255-6229
Practice Address - Fax:718-255-1288
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-25
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist