Provider Demographics
NPI:1952556979
Name:ABABAO-ALEXANDER, NOIDA ANNA (PT)
Entity Type:Individual
Prefix:
First Name:NOIDA
Middle Name:ANNA
Last Name:ABABAO-ALEXANDER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 S WALNUT BEND RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7279
Mailing Address - Country:US
Mailing Address - Phone:901-756-9944
Mailing Address - Fax:
Practice Address - Street 1:275 S WALNUT BEND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7279
Practice Address - Country:US
Practice Address - Phone:901-756-9944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3273225100000X
TN7212225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist