Provider Demographics
NPI:1205194164
Name:ABUAN, LALAINE L (PT)
Entity type:Individual
Prefix:
First Name:LALAINE
Middle Name:L
Last Name:ABUAN
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:LALAINE
Other - Middle Name:G
Other - Last Name:LUNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:4702 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-6125
Mailing Address - Country:US
Mailing Address - Phone:718-532-4705
Mailing Address - Fax:347-732-9011
Practice Address - Street 1:4702 47TH AVE
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-6125
Practice Address - Country:US
Practice Address - Phone:718-532-4705
Practice Address - Fax:347-732-9011
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033809261QP2000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy