Provider Demographics
NPI:1952894750
Name:TIEN, RIZALINE BELORO (PT)
Entity Type:Individual
Prefix:
First Name:RIZALINE
Middle Name:BELORO
Last Name:TIEN
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 1:3305 90TH ST # ST2H
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-1679
Mailing Address - Country:US
Mailing Address - Phone:718-200-5719
Mailing Address - Fax:
Practice Address - Street 1:3636 MAIN ST
Practice Address - Street 2:STE 2SD
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-6549
Practice Address - Country:US
Practice Address - Phone:718-353-8424
Practice Address - Fax:718-353-8142
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031413225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty