Provider Demographics
NPI:1770807877
Name:AGUILAR, ANA RHEEDA DEL MUNDO (DPT)
Entity type:Individual
Prefix:
First Name:ANA RHEEDA
Middle Name:DEL MUNDO
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 55TH ST
Mailing Address - Street 2:APT 1
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-1906
Mailing Address - Country:US
Mailing Address - Phone:646-500-0607
Mailing Address - Fax:
Practice Address - Street 1:55 NORTHERN BLVD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4027
Practice Address - Country:US
Practice Address - Phone:516-466-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-17
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030854225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist