Provider Demographics
NPI:1669197984
Name:IGPIT, BEA ANGELA GUIMALAN (PT)
Entity type:Individual
Prefix:MS
First Name:BEA ANGELA
Middle Name:GUIMALAN
Last Name:IGPIT
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 1:7011 108TH ST APT 1H
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4404
Mailing Address - Country:US
Mailing Address - Phone:260-221-7905
Mailing Address - Fax:
Practice Address - Street 1:3201 GRAND CONCOURSE APT 1A
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-1226
Practice Address - Country:US
Practice Address - Phone:718-644-3906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04568301225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist