Provider Demographics
NPI:1124426689
Name:DELOS TRINO, ABIGAIL JAUREGUI (PT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JAUREGUI
Last Name:DELOS TRINO
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 1:18 RIDGEWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-4264
Mailing Address - Country:US
Mailing Address - Phone:914-246-4881
Mailing Address - Fax:
Practice Address - Street 1:100 GREEN LN STE 1
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:PA
Practice Address - Zip Code:19007-5609
Practice Address - Country:US
Practice Address - Phone:215-826-0166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036776225100000X
FL32470225100000X
PAPT028420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist