Provider Demographics
NPI:1649969544
Name:REMOROSA, MIHO CERENO (PTA)
Entity type:Individual
Prefix:
First Name:MIHO
Middle Name:CERENO
Last Name:REMOROSA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5144 GOLDSMITH ST APT 3C
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4241
Mailing Address - Country:US
Mailing Address - Phone:628-529-7828
Mailing Address - Fax:
Practice Address - Street 1:5144 GOLDSMITH ST APT 3C
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4241
Practice Address - Country:US
Practice Address - Phone:628-529-7828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013302-01225200000X
NY051081-01225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant