Provider Demographics
NPI:1225864135
Name:VASQUEZ, FELIPE (PTA)
Entity type:Individual
Prefix:
First Name:FELIPE
Middle Name:
Last Name:VASQUEZ
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 564411
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-4411
Mailing Address - Country:US
Mailing Address - Phone:917-818-6776
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 564411
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-4411
Practice Address - Country:US
Practice Address - Phone:917-818-6776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant