Individual
MR. TEOFILO RABANERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6419 83RD PL # 2F, MIDDLE VILLAGE, NY 11379-2421
(347) 545-7550
Mailing address
6419 83RD PL # 2F, MIDDLE VILLAGE, NY 11379-2421
(347) 545-7550
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
8173286
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8173286
LICENSE NUMBER
NY
Enumeration date
05/23/2018
Last updated
05/23/2018
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