Provider Demographics
NPI:1336389428
Name:CALVEZ, ROWENA B
Entity Type:Individual
Prefix:MRS
First Name:ROWENA
Middle Name:B
Last Name:CALVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MR
Other - First Name:RODRIGO
Other - Middle Name:A
Other - Last Name:BANTING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPT
Mailing Address - Street 1:9408 214TH PL
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-1725
Mailing Address - Country:US
Mailing Address - Phone:718-468-2989
Mailing Address - Fax:718-468-2989
Practice Address - Street 1:9408 214TH PL
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11428-1725
Practice Address - Country:US
Practice Address - Phone:718-468-2989
Practice Address - Fax:718-468-2989
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist