| Doctor Name: | MISS MARIA CELIA EVANGELISTA |
| NPI Number: | 1265502678 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | 40QA01192400 |
| Business Practice Address: | 4175 Veteran Memorial Hwy Suite 202 Ronkonkoma, NY - 117797639 |
| Business Phone Number: | 6315805200 |
| Business Fax Number: | 6315805222 |
| Mailing Address: | 77 Newark Ave, Suite A&b BELLEVILLE |
| State: | NJ |
| Postal Code: | 071094143 |
| Phone Number: | 9737591100 |
| Fax Number: | 9737591170 |
| NPI Enumeration Date: | 11/09/2006 |
| NPI Last Update Date: | 11/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA01192400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |