Provider Demographics
NPI:1932344801
Name:LAVARELLO, HECTOR ALFONSO (PT, MS)
Entity Type:Individual
Prefix:MR
First Name:HECTOR
Middle Name:ALFONSO
Last Name:LAVARELLO
Suffix:
Gender:M
Credentials:PT, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 JULIUS RD
Mailing Address - Street 2:UNIT 12 A
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1265
Mailing Address - Country:US
Mailing Address - Phone:718-661-3996
Mailing Address - Fax:
Practice Address - Street 1:334 JULIUS RD
Practice Address - Street 2:UNIT 12A
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1265
Practice Address - Country:US
Practice Address - Phone:718-661-3996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015484-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics