Provider Demographics
NPI:1770813537
Name:BESA, CHUCK ARCILLA (PT)
Entity type:Individual
Prefix:MR
First Name:CHUCK
Middle Name:ARCILLA
Last Name:BESA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1554 UNIONPORT RD
Mailing Address - Street 2:APT 49 MB
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7819
Mailing Address - Country:US
Mailing Address - Phone:347-274-4305
Mailing Address - Fax:
Practice Address - Street 1:229 E 21ST ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-6433
Practice Address - Country:US
Practice Address - Phone:212-473-3703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028044-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist