Provider Demographics
NPI:1053326421
Name:DE OCA, SHEELA P (PT)
Entity type:Individual
Prefix:MRS
First Name:SHEELA
Middle Name:P
Last Name:DE OCA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:SHEELA
Other - Middle Name:P
Other - Last Name:EXITO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:216 STAPLES ST
Mailing Address - Street 2:2F
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4241
Mailing Address - Country:US
Mailing Address - Phone:516-752-2172
Mailing Address - Fax:
Practice Address - Street 1:475 NORTHERN BLVD STE 11
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4802
Practice Address - Country:US
Practice Address - Phone:516-829-0030
Practice Address - Fax:516-466-7723
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019138225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist