Provider Demographics
NPI:1124068648
Name:NOCEDA, JOHN MANUEL CHAN (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN MANUEL
Middle Name:CHAN
Last Name:NOCEDA
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:5535 NETHERLAND AVE
Mailing Address - Street 2:APARTMENT 3G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-2341
Mailing Address - Country:US
Mailing Address - Phone:914-886-8794
Mailing Address - Fax:347-427-3038
Practice Address - Street 1:55 E 124TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-1815
Practice Address - Country:US
Practice Address - Phone:212-410-8090
Practice Address - Fax:212-410-8403
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY026286225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist