Individual
MISS MICHELLE ROXAS NATIVIDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
111 CENTRE AVE UNIT 164, NEW ROCHELLE, NY 10801-7276
(818) 919-8861
Mailing address
111 CENTRE AVE UNIT 164, NEW ROCHELLE, NY 10801-7276
(818) 919-8861
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
028628-1
NY
225100000X
Physical Therapist
028628
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028628-1
LISCENSE
NY
Enumeration date
10/02/2007
Last updated
03/06/2025
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