Provider Demographics
NPI:1700456613
Name:PANLILIO, ROWENA ANGELA
Entity Type:Individual
Prefix:
First Name:ROWENA
Middle Name:ANGELA
Last Name:PANLILIO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 EDEN DR UNIT 6
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7120
Mailing Address - Country:US
Mailing Address - Phone:203-770-7383
Mailing Address - Fax:
Practice Address - Street 1:9 EDEN DR UNIT 6
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7120
Practice Address - Country:US
Practice Address - Phone:203-770-7383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026926225700000X
NY026926-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist