Provider Demographics
NPI:1285943506
Name:ONG, COLEEN CHARLOTTE RABE (MPT)
Entity type:Individual
Prefix:
First Name:COLEEN CHARLOTTE
Middle Name:RABE
Last Name:ONG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4205 FRANCIS LEWIS BLVD
Mailing Address - Street 2:1 FL
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2573
Mailing Address - Country:US
Mailing Address - Phone:718-888-7727
Mailing Address - Fax:718-269-9558
Practice Address - Street 1:4205 FRANCIS LEWIS BLVD
Practice Address - Street 2:1 FL
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2573
Practice Address - Country:US
Practice Address - Phone:718-888-7727
Practice Address - Fax:718-269-9558
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY029183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist