Provider Demographics
NPI:1184712317
Name:CHEQUE, MIGUEL ANGEL (PT)
Entity type:Individual
Prefix:MR
First Name:MIGUEL
Middle Name:ANGEL
Last Name:CHEQUE
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 1:345 E 94TH ST
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-5684
Mailing Address - Country:US
Mailing Address - Phone:212-534-1500
Mailing Address - Fax:212-860-8538
Practice Address - Street 1:345 E 94TH ST
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-5684
Practice Address - Country:US
Practice Address - Phone:212-534-1500
Practice Address - Fax:212-860-8538
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019530225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ18C61Medicare ID - Type UnspecifiedP.T.