Provider Demographics
NPI:1679391213
Name:FUENTEBELLA, RHEA ESCARO (PT)
Entity type:Individual
Prefix:
First Name:RHEA
Middle Name:ESCARO
Last Name:FUENTEBELLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8644 57TH AVE APT 1F
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4838
Mailing Address - Country:US
Mailing Address - Phone:917-444-0892
Mailing Address - Fax:
Practice Address - Street 1:ASHA DUA PHYSICAL THERAPY
Practice Address - Street 2:2035 RALPH AVE, SUITE B10
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5300
Practice Address - Country:US
Practice Address - Phone:718-251-4878
Practice Address - Fax:718-251-3011
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty