Provider Demographics
NPI:1255611810
Name:MAGBAG, JOSEPHINE F M
Entity type:Individual
Prefix:MRS
First Name:JOSEPHINE F
Middle Name:M
Last Name:MAGBAG
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JOSEPHINE F
Other - Middle Name:C
Other - Last Name:MAGPANTAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9910 METROPOLITAN AVE # 1F
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6638
Mailing Address - Country:US
Mailing Address - Phone:718-263-2273
Mailing Address - Fax:718-263-2278
Practice Address - Street 1:99-10 METROPOLITAN AVENUE 1F
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-263-2273
Practice Address - Fax:718-263-2278
Is Sole Proprietor?:No
Enumeration Date:2011-08-26
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006260-1225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant