Provider Demographics
NPI:1033943600
Name:ESQUIVEL, JESUS RAPHAEL (DPT, PT)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:RAPHAEL
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 CROWN ST APT 3I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-5342
Mailing Address - Country:US
Mailing Address - Phone:682-266-1200
Mailing Address - Fax:
Practice Address - Street 1:883 65TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4737
Practice Address - Country:US
Practice Address - Phone:682-266-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP130445225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist