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Individual

CHARMAINE IRISH LONGAKIT JUARIO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1345 AVENUE OF THE AMERICAS, 11TH FLOOR, NEW YORK, NY 10105
(212) 981-1977
(646) 786-4026
Mailing address
24 SUNNYSIDE DR, SPRINGFIELD, IL 62702
(217) 610-0058

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
041321
NY
225100000X
Physical Therapist
Primary
070023561
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
236
DC
01
568946544
BCBS
01
5874
HEALTH PARTNERS
Enumeration date
07/15/2022
Last updated
07/15/2022
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