Provider Demographics
NPI:1194741470
Name:RIUS, JOHN PHILIP CALLEJA (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN PHILIP
Middle Name:CALLEJA
Last Name:RIUS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9825 64TH RD APT 2D
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3401
Mailing Address - Country:US
Mailing Address - Phone:718-606-2654
Mailing Address - Fax:
Practice Address - Street 1:6607 ALDERTON ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-5205
Practice Address - Country:US
Practice Address - Phone:718-275-7790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026771225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist