Doctor Name: | PAUL HENRY VAZQUEZ |
NPI Number: | 1124174396 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S., P.T. |
License Number: | 018893-1 |
Business Practice Address: | 457 Clay Pitts Rd East Northport, NY - 117313821 |
Business Phone Number: | 6314868572 |
Business Fax Number: | 6313684975 |
Mailing Address: | 457 Clay Pitts Rd, EAST NORTHPORT |
State: | NY |
Postal Code: | 117313821 |
Phone Number: | 6314868572 |
Fax Number: | 6313684975 |
NPI Enumeration Date: | 01/28/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 018893-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |