Provider Demographics
NPI:1841501384
Name:LAINO, FIL-ANGELIE GONZALES
Entity type:Individual
Prefix:
First Name:FIL-ANGELIE
Middle Name:GONZALES
Last Name:LAINO
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 1:14118 78TH AVE
Mailing Address - Street 2:APT. 2D
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3377
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14118 78TH AVE
Practice Address - Street 2:APT. 2D
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3377
Practice Address - Country:US
Practice Address - Phone:347-617-8777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030869-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist