Wendell Jamias Abad

Individual provider Active NPI Physical Therapy Assistant · Jackson Heights, NY

NPI 1134732142 · NPPES record last updated Aug 28, 2020

Key facts

NPI
1134732142
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
007790-1 (NY)
Practice address
90-33 Elmhurst Ave.
Jackson Heights, NY 11372
Phone
(718) 565-2970
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
007790-1NYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant
Group: 193400000X SINGLE SPECIALTY GROUP
225200000X 007790-1 NY Yes

Addresses

Primary practice location

90-33 Elmhurst Ave.
Jackson Heights, NY 11372

Mailing address

90-33 Elmhurst Ave.
Jackson Heights, NY 11372
Phone (718) 565-2970

Other providers in Jackson Heights, NY

All providers in Jackson Heights, NY · Physical Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.