Provider Demographics
NPI:1154182079
Name:CAMINOS, MADONNA BADAYOS (PT)
Entity type:Individual
Prefix:
First Name:MADONNA
Middle Name:BADAYOS
Last Name:CAMINOS
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 1:229 COCHRAN PL
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2933
Mailing Address - Country:US
Mailing Address - Phone:347-538-0771
Mailing Address - Fax:
Practice Address - Street 1:229 COCHRAN PL
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-2933
Practice Address - Country:US
Practice Address - Phone:347-538-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY044581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist