Provider Demographics
NPI:1548858095
Name:BAYONA, BEATRICE (PT, DPT)
Entity type:Individual
Prefix:
First Name:BEATRICE
Middle Name:
Last Name:BAYONA
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:959 FLOYD AVE APT 14
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-4543
Mailing Address - Country:US
Mailing Address - Phone:718-561-9302
Mailing Address - Fax:
Practice Address - Street 1:950 FLOYD AVE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-4535
Practice Address - Country:US
Practice Address - Phone:315-336-5400
Practice Address - Fax:315-336-1536
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY041200225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist