Provider Demographics
NPI:1184905085
Name:BELMONTE, MYLA YUZON (PT)
Entity type:Individual
Prefix:
First Name:MYLA
Middle Name:YUZON
Last Name:BELMONTE
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 1:8706 58TH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4821
Mailing Address - Country:US
Mailing Address - Phone:347-832-7600
Mailing Address - Fax:
Practice Address - Street 1:28 BEVERLY CT
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-2115
Practice Address - Country:US
Practice Address - Phone:347-832-7600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031264-1261QP2000X
NJ40QA01470300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy