Provider Demographics
NPI:1386973295
Name:MACAPAGAL, ELOISA GIMENEZ (PT)
Entity type:Individual
Prefix:MRS
First Name:ELOISA
Middle Name:GIMENEZ
Last Name:MACAPAGAL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-3913
Mailing Address - Country:US
Mailing Address - Phone:516-510-6692
Mailing Address - Fax:
Practice Address - Street 1:125 FRANKLIN AVENUE
Practice Address - Street 2:ISLAND MUSCULOSKELETAL CARE MD PC
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-2108
Practice Address - Country:US
Practice Address - Phone:516-374-6838
Practice Address - Fax:516-374-2362
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032170225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist