Provider Demographics
NPI:1699497909
Name:VALERIO, NADEZNA JOELLE RICAPLAZA (PT)
Entity type:Individual
Prefix:MS
First Name:NADEZNA JOELLE
Middle Name:RICAPLAZA
Last Name:VALERIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NADEZNA JOELLE
Other - Middle Name:VALERIO
Other - Last Name:PUNONGBAYAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1345 AVENUE OF THE AMERICAS
Mailing Address - Street 2:15TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10105
Mailing Address - Country:US
Mailing Address - Phone:212-981-1977
Mailing Address - Fax:
Practice Address - Street 1:1345 AVENUE OF THE AMERICAS
Practice Address - Street 2:15TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10105
Practice Address - Country:US
Practice Address - Phone:212-981-1977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013414225200000X
NY049195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA067747417OtherUSCIS